How simulation modeling can support the public health response to the opioid crisis in North America: Setting priorities and assessing value.
How simulation modeling can support the public health response to the opioid crisis in North America: Setting priorities and assessing value.
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DOI：
10.1016/j.drugpo.2020.102726
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
OUD Modeling writing group
中科院分区：
文献类型：
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作者：
OUD Modeling writing group
阿片类药物相关危害是北美的一个主要公共卫生问题。在美国和加拿大，2017年分别有超过72，000人和约4100人死于药物过量，其中绝大多数与阿片类药物有关（加拿大政府，2018年;国家药物滥用研究所，2019年）。自1979年以来，美国的阿片类药物相关过量死亡一直呈指数增长，非法合成阿片类药物的引入推动了最近的增长（Jalal等人，2018年）。过量是阿片类药物使用障碍的高患病率的一种表现（OUD，Bose等人，2016）其他结果包括血源性感染（特别是艾滋病毒和丙型肝炎病毒（HCV））的局部爆发，以及血管内感染发生率的上升（Bates，Annie，Jha &科恩斯，2019; Inocencio，卡罗尔，Read & Holdford，2013; Schwetz，Calder，Rosenthal，Kattakuzhy & Fauci，2019; Springer，Korthuis &德尔里奥，2019; Strassels，2009;白色，Birnbaum和Mareva，2005年）。关于OUD患者长期管理的问题-从减少伤害服务的可用性到使用药物治疗OUD（MOUD;用于区分药物治疗和心理社会护理的术语（通常与治疗相关，布兰科& Alcow，2019），以增加HCV治疗的可及性，已成为公共卫生和医疗保健提供的优先主题（Blanchard，韦斯，Barrett，McDermott & Heslin，2018;布兰科& Heslow，2019; Habib，Gouriet & Casalta，2019）。虽然现在有许多针对OUD患者的循证干预措施，但这些措施的利用率很低，而且在社区和区域两级选择最佳干预措施（包括各种干预措施的组合和实施规模）和交付方面仍然存在问题。根据2017年全国药物使用和健康调查，只有四分之一的OUD美国人接受过任何护理（物质滥用和精神健康服务管理局，2018），不到三分之一的人接受过任何MOUD（物质滥用和精神健康服务管理局，2018，物质滥用和精神健康服务管理局，2018）。
Opioid-related harms are a major public health concern in North America. In the United States and Canada, respectively, over 72,000 and about 4100 people died of a drug overdose in 2017, the vast majority of which were opioid-related (Government of Canada, 2018; National Institute on Drug Abuse, 2019). Opioid-related overdose deaths in the United States have been increasing on an exponential trajectory since 1979, with the introduction of illicit synthetic opioids driving the most recent increases (Jalal et al., 2018). Overdose is one manifestation of the high prevalence of opioid use disorder (OUD, Bose et al., 2016) other outcomes include localized outbreaks of bloodborne infections, particularly HIV and hepatitis C virus (HCV), and rising incidence of endovascular infections (Bates, Annie, Jha & Kerns, 2019; Inocencio, Carroll, Read & Holdford, 2013; Schwetz, Calder, Rosenthal, Kattakuzhy & Fauci, 2019; Springer, Korthuis & Del Rio, 2019; Strassels, 2009; White, Birnbaum & Mareva, 2005).Questions about the long-term management of people with OUD–from availability of harm reduction services to use of medications to treat OUD (MOUD; terminology used to distinguish pharmacotherapies from psychosocial care often associated with treatment Blanco & Volkow, 2019) to increasing access to HCV treatment–have become priority topics in public health and healthcare delivery (Blanchard, Weiss, Barrett, McDermott & Heslin, 2018; Blanco & Volkow, 2019; Habib, Gouriet & Casalta, 2019). While many evidence-based interventions for people with OUD are now available, they are significantly underutilized and questions remain regarding optimal intervention selection (including the mix of interventions and the scale of implementation for each) and delivery at community and regional levels. According to the 2017 National Survey on Drug Use and Health, only one in four Americans with an OUD received any care,(Substance Abuse & Mental Health Services Administration, 2018) and fewer than a third of those who are in care received any MOUD (Substance Abuse & Mental Health Services Administration, 2018, Substance Abuse & Mental Health Services Administration, 2018).