Methadone Matters: What the United States Can Learn from the Global Effort to Treat Opioid Addiction
Methadone Matters: What the United States Can Learn from the Global Effort to Treat Opioid Addiction
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DOI：
10.1007/s11606-018-4801-3
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发表时间：
2019-06-01
影响因子：
5.7
通讯作者：
Samet, J. H.
中科院分区：
文献类型：
--
作者：
Calcaterra, S. L.;Bach, P.;Samet, J. H.
在阿片类药物流行期间，与阿片类药物过量相关的死亡率在美国继续上升。治疗类阿片使用障碍的药物，包括美沙酮和丁丙诺啡，在降低与非法使用类阿片有关的发病率和死亡率方面非常有效。尽管这些挽救生命的药物有效，但大多数阿片类药物使用障碍患者缺乏获得治疗的机会。本文简要回顾了支持使用药物治疗阿片类药物使用障碍的证据，特别关注美沙酮。我们讨论了美沙酮治疗阿片类药物使用障碍在美国的现状，并提出了限制其使用的后勤障碍。接下来，我们研究了三种基于国际药房的模型，其中美沙酮配药治疗阿片类药物使用障碍发生在阿片类药物治疗设施之外。我们讨论了目前的挑战和机遇，将类似的方法美沙酮配药阿片类药物使用障碍的治疗在美国。最后，我们提出了我们的愿景，通过临床医生和药房之间的合作，将基于药房的美沙酮配药纳入常规阿片类药物使用障碍治疗，以改善当地获得这种挽救生命的药物。
In the midst of an opioid epidemic, mortality related to opioid overdose continues to rise in the US. Medications to treat opioid use disorder, including methadone and buprenorphine, are highly effective in reducing the morbidity and mortality related to illicit opioid use. Despite the efficacy of these life-saving medications, the majority of people with an opioid use disorder lack access to treatment. This paper briefly reviews the evidence to support the use of medications to treat opioid use disorder with a specific focus on methadone. We discuss the current state of methadone therapy for the treatment of opioid use disorder in the US and present logistical barriers that limit its use. Next, we examine three international pharmacy-based models in which methadone dispensing to treat opioid use disorder occurs outside of an opioid treatment facility. We discuss current challenges and opportunities to incorporate similar methods of methadone dispensing for the treatment of opioid use disorder in the US. Finally, we present our vision to integrate pharmacy-based methadone dispensing into routine opioid use disorder treatment through collaboration between clinicians and pharmacies to improve local access to this life-saving medication.