医疗补助和甲用于阿片类药物使用障碍:扩大覆盖范围增加了2019-24年10个州的分发
Ellen Latsko1, Alina Denham2, Michael L Barnett3
1Ellen Latsko, Brown University, Providence, Rhode Island.
Health affairs (Project Hope)
|August 20, 2025
概括
支持法案增加了阿片类药物使用障碍治疗的甲分发. 然而,阿片类药物过量死亡人数也有所增加,这凸显了除了药物覆盖范围之外,还需要全面的成治疗政策.
科学领域:
- 公共卫生
- 药理学
- 卫生政策
背景情况:
- 甲对于阿片类药物使用障碍 (OUD) 治疗至关重要,但由于监管障碍,其在历史上未得到充分利用.
- 在2018年之前,不一致的医疗补助计划限制了许多患者获得甲治疗.
- 药物使用障碍预防促进阿片类药物恢复和治疗患者和社区 (SUPPORT) 法案旨在通过强制性医疗补助覆盖来扩大获取范围.
研究的目的:
- 评估SUPORT法案扩大医疗保险对甲分发率的影响.
- 评估扩大甲覆盖率与阿片类药物过量死亡的趋势之间的关联.
主要方法:
- 使用受控物质分布数据 (2016-2024) 和国家死亡数据.
- 采用了比较方法,将新加入医疗补助计划的州与已有医疗补助计划的州对比.
- 在实施政策之前和之后分析了甲分布和阿片类药物过量死亡的变化.
主要成果:
- 扩大医疗补助对甲的覆盖范围与人口水平甲分布的显著增加有关 (86.6克/ 100,000人口,相对变化为 13.2%).
- 与对照国家相比,新覆盖州的阿片类药物过量死亡人数增加了14.4%.
- 这些发现表明对甲的可用性有积极影响,但并没有同时减少过量死亡.
结论:
- 支持法案成功地提高了人口水平上阿片类药物使用障碍治疗的甲分发.
- 与此同时,阿片类药物过量死亡人数的增加表明,仅增加药物获取是不够的.
- 为了有效应对持续的阿片类药物危机,需要更广泛的药物治疗政策解决方案.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
426
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
426
Prescription, Nonprescription and Orphan Drugs
844
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
844
Opioid Analgesics: Morphine and Other Natural Cogeners
361
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
361
Drug Abuse and Addiction: Pharmacological Phenomena
655
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
655
Drug Delivery: Miscellaneous Routes
468
Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection, and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
468
Healthcare Agencies II
749
There are various healthcare agencies in the United States—some of which are managed by religious institutions and others by different government branches.
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
749


