Commentary on Piske et al. (2020): Medication initiation is key to reduce deaths amid opioid crisis.
Commentary on Piske et al. (2020): Medication initiation is key to reduce deaths amid opioid crisis.
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对皮斯克等人的评论。
DOI：
10.1111/add.15022
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Williams,ArthurRobin
中科院分区：
文献类型：
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作者：
Williams,ArthurRobin
OUD Cascade of Care是一个公共卫生框架，用于指导更有效地应对阿片类药物流行的努力。官员可以跟踪从诊断到恢复的每个阶段的进展，以帮助确定系统之间的差距。这可能对改善更复杂患者人群的结局特别有意义。OUD级联护理已成为公共卫生机构监测阿片类药物流行病进展的首选框架[1，2]。与美国许多地区的趋势类似，Piske及其同事[3]观察到不列颠哥伦比亚省被诊断患有阿片类药物使用障碍（OUD）的人数增加了三倍以上，该省是加拿大省级阿片类药物相关死亡率最高的省份。然而，加拿大已经为OUD开发了一个更大的和低门槛的处理系统，其他国家，特别是美国，可以学习。事实上，作者解释说，最常用的阿片类激动剂治疗（OAT）形式，美沙酮和丁丙诺啡/纳洛酮，可以由初级医生开处方[不需要缉毒局（DEA）的X豁免]，并通过社区药店分发-这是美国联邦机构长期拒绝允许的[4]。自2017年年中以来，OAT的替代形式，包括缓释口服吗啡和注射剂，也在这些低门槛环境中提供。
The OUD Cascade of Care is a public health framework for guiding efforts to more effectively respond to the opioid epidemic. Officials can track progress across each stage, from diagnosis to recovery, to help identify gaps across systems. This may be especially meaningful for improving outcomes among more complex patient populations.The OUD Cascade of Care has become a preferred framework for public health agencies monitoring progress amid the opioid epidemic [1, 2]. Similar to trends in many parts of the United States, Piske and colleagues [3] observed a greater than threefold increase in the number of individuals diagnosed with opioid use disorder (OUD) across British Columbia, which has the highest provincial opioid-related death rate in Canada. Canada, however, has developed a much more capacious and low-threshold treatment system for OUD which other countries, especially the United States, could learn from. Indeed, the authors explain that the most commonly used forms of opioid agonist treatment (OAT), methadone and buprenorphine/naloxone, can be prescribed by primary physicians [with no need for a Drug Enforcement Administration (DEA)‘X-waiver’] and dispensed via community-based pharmacies—something that US federal agencies have long refused to allow [4]. Since mid-2017 alternative forms of OAT, including slow-release oral morphine and injectables, have also been offered in these low-threshold settings.