Where Is the Opioid Use Epidemic in Mexico? A Cautionary Tale for Policymakers South of the US-Mexico Border
Where Is the Opioid Use Epidemic in Mexico? A Cautionary Tale for Policymakers South of the US-Mexico Border
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DOI：
10.2105/ajph.2018.304767
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发表时间：
2019-01-01
影响因子：
12.7
通讯作者：
Werb, Dan
中科院分区：
文献类型：
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作者：
Goodman-Meza, David;Medina-Mora, Maria Elena;Werb, Dan
在北美，过去20年来，美国和加拿大的阿片类药物使用及其危害有所增加。然而，墨西哥尚未记录表明阿片类药物使用水平较高或随之而来的危害的模式。从历史上看，墨西哥一直是阿片类药物使用水平较低的国家，尽管有海洛因使用的记录。阿片类药物的低水平使用可能归因于结构、文化和个人因素。然而，一系列动态因素可能正在汇合，增加类阿片的使用：类阿片处方的立法变化，类阿片的国家健康保险覆盖范围，制药业的压力，不断变化的人口统计和疾病负担，被迫移徙及其创伤，以及海洛因生产和贩运的增加。墨西哥可能从类阿片使用率低的国家过渡到类阿片使用率高的国家，但有机会通过对高风险群体进行有针对性的公共卫生监测、准备适当的基础设施以支持循证治疗以及采取干预措施和政策以避免类阿片使用流行病的广泛蔓延来有效应对。
In North America, opioid use and its harms have increased in the United States and Canada over the past 2 decades. However, Mexico has yet to document patterns suggesting a higher level of opioid use or attendant harms.Historically, Mexico has been a country with low-level use of opioids, although heroin use has been documented. Low-level opioid use is likely attributable to structural, cultural, and individual factors. However, a range of dynamic factors may be converging to increase the use of opioids: legislative changes to opioid prescribing, national health insurance coverage of opioids, pressure from the pharmaceutical industry, changing demographics and disease burden, forced migration and its trauma, and an increase in the production and trafficking of heroin. In addition, harm-reduction services are scarce.Mexico may transition from a country of low opioid use to high opioid use but has the opportunity to respond effectively through a combination of targeted public health surveillance of high-risk groups, preparation of appropriate infrastructure to support evidence-based treatment, and interventions and policies to avoid a widespread opioid use epidemic.