Naloxone's role in the national opioid crisis-past struggles, current efforts, and future opportunities.
Naloxone's role in the national opioid crisis-past struggles, current efforts, and future opportunities.
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DOI：
10.1016/j.trsl.2021.03.001
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Elliott L
中科院分区：
文献类型：
--
作者：
Bennett AS;Elliott L
在过去的25年里，纳洛酮已经成为一种关键的救命药物。公共卫生倡导者和社区积极分子建立了向注射吸毒者分发纳洛酮的早期方法，但污名化和反对普遍获得纳洛酮的遗留问题继续限制了该药物降低阿片类药物相关死亡率的全部潜力。在注射器交换计划的保护伞下建立纳洛酮分发计划，面临着与注射器交换计划本身类似的实际、意识形态和财务障碍，以扩大规模。纳洛酮从几个注射器交换计划的范围扩大到我们今天看到的情况，对于一直在为保证获得纳洛酮而斗争的基层活动家、服务提供商和公共卫生专业人员来说，是一个巨大的胜利。尽管为扩大纳洛酮的使用做出了广泛努力，但纳洛酮在美国许多地区仍然是一种稀缺资源。相当大的纳洛酮“沙漠”仍然存在，即使在有纳洛酮通道的地方，也不总是能接触到那些处于危险之中的人。有望扩大的领域包括为纳洛酮分发开发更强大的远程医疗方法，包括补贴邮件递送计划；降低药房准入门槛；与医院、救护车和执法部门合作扩大纳洛酮“留下”计划；提供纳洛酮与阿片使用障碍药物的联合处方；以及与监狱、收容所和使用药物的人网络合作，以增加获得救命药物的机会。确保非处方药和低成本或免费纳洛酮的努力正在进行中，并与药物辅助治疗并驾齐驱，作为有效、易于操作和成本效益高的人群一级干预措施，可用于打击美国与阿片类药物相关的过量使用。(《翻译研究》2021；000：115)
Over the past 25 years, naloxone has emerged as a critical lifesaving overdose antidote. Public health advocates and community activists established early methods for naloxone distribution to people who inject drugs, but a legacy of stigmatization and opposition to universal naloxone access continues to limit the drug’s full potential to reduce opioid-related mortality. The establishment of naloxone distribution programs under the umbrella of syringe exchange programs faces the same practical, ideological and financial barriers to expansion similar to those faced by syringe exchange programs themselves. The expansion of naloxone from the confines of a few syringe exchange programs to what we see today represents an enormous triumph for the grass-roots activists, service providers, and public health professionals who have fought to guarantee lay access to naloxone. Despite the extensive efforts to expand access to naloxone, naloxone continues to remains a scarce resource in many US localities. Considerable naloxone “deserts” remain and even where there is naloxone access, it does not always reach those at risk. Promising areas for expansion include the development of more robust telehealth methods for naloxone distribution, including subsidized mail delivery programs; lowering barriers to pharmacy access; working with hospitals, ambulances, and law enforcement to expand naloxone “leave behind” programs; providing naloxone co-prescription with medications for opioid use disorder; and working with prisons, shelters, and networks of people who use drugs to increase access to the lifesaving medication. Efforts to ensure over-the-counter and low- or no-cost naloxone are ongoing and stand alongside medication-assisted treatments as efficacious, readily-actionable, and cost-efficient population-level interventions available for combatting opioid-related overdose in the United States. (Translational Research 2021; 000:115)
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影响因子：
2
作者：
Bennett AS;Elliott L;Golub A;Wolfson-Stofko B;Guarino H
通讯作者：
Guarino H
影响因子：
3.5
作者：
Bell, Alice;Bennett, Alex S.;Williams, Leslie D.
通讯作者：
Williams, Leslie D.
影响因子：
2.8
作者：
Bennett, Alex S.;Bell, Alice;Davis, Corey
通讯作者：
Davis, Corey
DOI：
10.1007/s11524-011-9600-7
发表时间：
2011-12-01
影响因子：
6.6
作者：
Bennett, Alex S.;Bell, Alice;Kral, Alex H.
通讯作者：
Kral, Alex H.
影响因子：
39
作者：
Abouk, Rahi;Pacula, Rosalie Liccardo;Powell, David
通讯作者：
Powell, David