法国和美国的甲政策和实践比较:对美国政策改革的影响
Honora Englander1, Mathieu Chappuy2, Noa Krawczyck3
1Section of Addiction Medicine in General Internal Medicine and the Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA; Service Universitaire d'Addictologie de Lyon, Centre Hospitalier Le Vinatier, Bron, France.
甲是阿片类药物使用障碍的关键治疗方法,在美国受到严格政策的限制. 法国通过将美沙整合到初级保健和药房中,提供更好的获取和更低的过量剂量率.
科学领域:
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
- 卫生政策 卫生政策
背景情况:
- 甲是一种高度有效的治疗阿片类药物使用障碍 (OUD).
- 目前的美国政策严重限制了甲的可用性和治疗方案.
- 法国证明了卓越的美沙获取和明显较低的过量死亡率.
研究的目的:
- 为了比较法国和美国的甲治疗政策和结果.
- 分析美国政策改革对甲可获得性的影响.
- 为考虑改变甲法规的美国政策制定者提供见解.
主要方法:
- 法国和美国甲治疗系统的比较分析.
- 审查当前和拟议的美国联邦和州政策.
- 检查治疗启动,发放和临床决策过程.
主要成果:
- 法国为87%的OUD患者提供甲,而美国估计为13-20%.
- 法国制度允许在专业机构进行启动,包括初级保健后续和药房处方.
- 美国系统将甲限制在阿片类药物治疗计划中,对剂量和访问进行严格的联邦控制.
结论:
- 美国的甲政策比法国更为严格,影响了治疗机会和治疗结果.
- 法国的模式,整合社区药房和共享决策,为美国改革提供了潜在的框架.
- 政策改革对于改善美沙的可用性和减少美国过量死亡至关重要.
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