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The “public health” approach to illicit drugs: an eradicative drug discourse in a sanitorial disguise? 对非法药物的"公共卫生"方针:卫生伪装下的根除性药物话语?
Q4 SUBSTANCE ABUSE Pub Date : 2022-12-22 DOI: 10.1108/dhs-09-2022-0030
Steven Debbaut, Tobias Kammersgaard
PurposeThis study aims to problematize current calls for a “public health” approach to governing illicit drugs and the people who use them.Design/methodology/approachIt draws on a range of historical sources to describe how drugs became a problem for governments, in order to critically diagnose the present and investigate the origins of current perspectives on drugs.FindingsIt is argued that there are currently two authoritative drug discourses. The first discourse is the dominant one and is eradicative, with blame and punishment as its primary responses. The second discourse is subauthoritative, but growing in importance, and is sanitorial, with care and cure as its primary responses.Originality/valueWhile these two discourses have often been thought of as distinct, this historical exploration demonstrates that the eradicative and sanitorial discourses are both based on similar principles.
目的:本研究旨在对当前呼吁采取"公共卫生"方法来管理非法药物及其使用者的问题提出质疑。设计/方法/方法它借鉴了一系列的历史资料来描述药物如何成为政府的一个问题,以便批判性地诊断当前和调查当前药物观点的起源。研究结果认为,目前有两种权威的药物话语。第一种话语占主导地位,是根除性的,指责和惩罚是它的主要反应。第二种话语是次权威的,但越来越重要,是卫生的,以护理和治疗为主要反应。虽然这两种话语通常被认为是不同的,但这一历史探索表明,根除和卫生话语都基于类似的原则。
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引用次数: 1
Challenges, policy and politics in drug checking: reflections of the TEDItorial team 药物检查中的挑战、政策和政治:编辑团队的思考
Q4 SUBSTANCE ABUSE Pub Date : 2022-11-29 DOI: 10.1108/dhs-10-2022-0037
Nicolas Van der Linden, Raoul Koning, Daan van der Gouwe, Mireia Ventura, F. Measham
PurposeThe purpose of this paper is to present some of the continued resistance and challenges faced by drug checking services (DCS) and review how the existing literature and the contributions to the special issue address them, with a view to making recommendations.Design/methodology/approachThe existing literature and the contributions to the special issue are reviewed.FindingsDrug checking cannot be equated with quality control. With the appropriate equipment and chemistry staff, DCS can provide quantitative analysis and reliable results. When the product does not match expectations, service users discard the tested substance of concern. To more easily compare the results of different studies and better evaluate drug checking, standardisation of measures is desirable. Uptake of drug checking, notably in festivals, is low and depends in part on the capacity of DCS. Drug checking has added value in monitoring drug markets and is complementary with chemical (forensic) analysis.Originality/valueThis paper interrogates in a relatively comprehensive way the continued resistance to drug checking in light of theoretical and empirical research to derive recommendations that are specific to drug checking and that are addressed to health professionals, researchers and also to policymakers.
本文旨在介绍药品检查服务(DCS)面临的一些持续的阻力和挑战,并回顾现有文献和对特刊的贡献,以期提出建议。设计/方法/方法回顾现有文献和对特刊的贡献。发现药品检查不能等同于质量控制。有了合适的设备和化学人员,DCS可以提供定量分析和可靠的结果。当产品不符合期望时,服务用户就会丢弃所关注的测试物质。为了更容易地比较不同研究的结果,更好地评价药物检查,需要标准化的措施。毒品检查的使用率很低,特别是在节日期间,这部分取决于DCS的能力。药物检查增加了监测毒品市场的价值,并与化学(法医)分析相辅相成。原创性/价值本文根据理论和实证研究,以相对全面的方式询问对药物检查的持续抵制,以得出针对药物检查的建议,并针对卫生专业人员、研究人员和政策制定者。
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引用次数: 0
Psychoactive substance use and drug checking practices among participants at electronic dance music events in Ukraine 乌克兰电子舞曲活动参与者的精神活性物质使用和药物检查做法
Q4 SUBSTANCE ABUSE Pub Date : 2022-11-24 DOI: 10.1108/dhs-10-2022-0035
Vyacheslav Kushakov, Vira Dvoriak, Olga O. Morozova, L. Azbel, Galyna Sergienko
PurposeTo the best of the authors’ knowledge, no study has previously examined the use of psychoactive substances (PASs) at electronic dance music (EDM) events in Ukraine. Addressing this gap in the research literature, this study aims to: describe the recreational drug scene associated with Ukrainian EDM culture; identify clusters of EDM participants who use PAS, based on their drug use patterns; and assess the uptake of drug checking and investigate associations between drug checking and subsequent drug-related behaviour.Design/methodology/approachA series of cross-sectional surveys were conducted in 2021 (N = 1,307) among EDM festival participants in Ukraine. The authors performed cluster analysis to identify distinct profiles of PAS users. Trends in drug checking were analysed based on cross-sectional surveys conducted at one recurring festival in 2018 (N = 99), 2019 (N = 195) and 2021 (N = 237).FindingsThe substances most often used at EDM events were 3,4-Methylenedioxymethamphetamine (37%), amphetamine (16%), lysergic acid diethylamide (11%) and cocaine (9%). Between 2018 and 2021, the proportion of participants who reported to have ever tested their drugs has increased from 2% to 26% (p < 0.001). Unexpected or inconclusive test results led to a significantly lower chances of drug consumption (p = 0.003). The authors identified three distinct clusters of PAS users among the EDM festival attendees in Ukraine.Originality/valueThis study will inform the development of harm reduction interventions tailored to various subgroups of recreational PAS users taking into account gender-specific patterns of use suggested by the authors’ cluster analysis. Increased availability of drug checking is crucial to reduce the risks of drug-related harm associated with the consumption of mis-sold, mislabeled and/or adulterated substances.
据作者所知,此前没有研究调查过乌克兰电子舞曲(EDM)活动中精神活性物质(PASs)的使用情况。为了解决研究文献中的这一空白,本研究旨在:描述与乌克兰EDM文化相关的娱乐性药物场景;根据药物使用模式确定使用PAS的EDM参与者群;评估药物检查的接受情况,调查药物检查与随后的药物相关行为之间的关系。设计/方法/方法在2021年对乌克兰EDM节参与者进行了一系列横断面调查(N = 1,307)。作者进行了聚类分析,以确定PAS用户的不同概况。通过2018年(N = 99)、2019年(N = 195)和2021年(N = 237)在一个经常性节日进行的横断面调查,分析药品检查的趋势。在EDM事件中最常使用的物质是3,4-亚甲二氧基甲基苯丙胺(37%)、安非他明(16%)、麦角酸二乙胺(11%)和可卡因(9%)。在2018年至2021年期间,报告曾经检测过药物的参与者比例从2%增加到26% (p < 0.001)。意外或不确定的检测结果导致药物消费的机会显著降低(p = 0.003)。作者在乌克兰的EDM节参与者中确定了三个不同的PAS用户群。原创性/价值本研究将根据作者的聚类分析建议的特定性别使用模式,为针对娱乐PAS用户的不同亚组量身定制减少危害干预措施的发展提供信息。增加药物检查的可得性对于减少与误售、贴错标签和/或掺假物质消费有关的药物相关伤害的风险至关重要。
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引用次数: 1
Échele Cabeza as a harm reduction project and activist movement in Colombia Échele Cabeza是哥伦比亚的一个减少伤害项目和活动家运动
Q4 SUBSTANCE ABUSE Pub Date : 2022-11-24 DOI: 10.1108/dhs-07-2022-0026
Mauro Díaz Moreno, Nathalia Alarcón Ayala, Y. Estrada, Vannesa Morris, Julián Quintero
PurposeThe purpose of this paper is to present the results and context of the drug checking service (DCS) performed by the harm reduction project Échele Cabeza (EC) in Colombia.Design/methodology/approachData from several years are presented with a focus on data from 2021. In 2021, data were derived from 2,339 questionnaires filled out by DCS users and a total of 2,868 drug checking test results from samples collected at the fixed-site service in Bogotá and 30 music festivals in 8 cities nationwide.FindingsThe tusi phenomenon is gaining strength in Colombia revealing a problem associated with the changing makeup of tusi and, thus, polydrug use. MDMA adulteration and misrepresentations have increased in comparison to 2019. There is an increasing number of people who want to use the DCS in Colombia, which is encouraging but also exposes the limitations of the drug checking methods available to EC.Originality/valueThis paper offers the first publication of the pioneering drug checking organization EC in Latin America.
本文的目的是介绍哥伦比亚减少危害项目Échele Cabeza (EC)执行的药物检查服务(DCS)的结果和背景。设计/方法/方法展示了几年的数据,重点是2021年的数据。2021年,数据来自DCS用户填写的2339份问卷,以及在波哥大固定站点服务和全国8个城市的30个音乐节收集的样本中总共2868份药物检查测试结果。在哥伦比亚,“土司”现象愈演愈烈,这揭示了一个与“土司”构成变化以及多种药物使用有关的问题。与2019年相比,MDMA掺假和虚假陈述有所增加。在哥伦比亚,想要使用DCS的人越来越多,这令人鼓舞,但也暴露了欧共体可用的药物检查方法的局限性。原创性/价值本文提供了拉丁美洲开创性药物检查组织EC的首次出版物。
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引用次数: 2
Size matters: comparing the MDMA content and weight of ecstasy tablets submitted to European drug checking services in 2012–2021 尺寸很重要:比较2012-2021年提交给欧洲药物检查服务的摇头丸片的MDMA含量和重量
Q4 SUBSTANCE ABUSE Pub Date : 2022-11-24 DOI: 10.1108/dhs-01-2022-0003
Ruben Q Vrolijk, F. Measham, Adrià Quesada, Anton Luf, Dominique Schori, Sarah Radley, D. Acreman, Josie Smith, Marko Verdenik, Daniel Martins, Mariana Cunha, C. Paulos, Ilaria Fineschi Piccinin, E. Gerace, Alexandra Karden, Raoul Koning, L. Smit‐Rigter, Mireia Ventura
PurposeThe 3,4-methylenedioxymetamphetamine (MDMA) content in ecstasy tablets has increased enormously throughout Europe across the past decade. This study aims to determine whether this is caused by the production of “stronger” tablets (more mg MDMA per mg of tablet), or if tablets have simply been getting larger and heavier (more mg of tablet in total).Design/methodology/approachA data set of 31,716 ecstasy tablets obtained in 2012–2021 by 10 members of the Trans European Drug Information (TEDI) network was analysed.FindingsThe MDMA mass fraction in ecstasy tablets has remained virtually unchanged over the past 10 years, with increased MDMA contents being attributed almost exclusively to increased tablet weight. These trends seem to be uniform across Europe, despite varying sampling and analytical techniques being used by the TEDI participants. The study also shows that while tablet weight correlates perfectly with MDMA content on a yearly basis, wide variations in the MDMA mass fraction make such relations irrelevant for determining the MDMA content of individual tablets.Research limitations/implicationsThese results provide new opportunities for harm reduction, given that size is a tangible and apparently accurate characteristic to emphasise that one tablet does not simply equate to one dose. This is particularly useful for harm reduction services without the resources for in-house quantification of large numbers of ecstasy tablets, although the results of this study also show that chemical analysis remains crucial for accurate personalised harm reduction.Originality/valueThe findings are both new and pertinent, providing a novel insight into the market dynamics of ecstasy tablet production at a transnational level.
目的在过去十年中,在整个欧洲,摇头丸片中的3,4-亚甲基二氧基甲基苯丙胺(MDMA)含量急剧增加。这项研究的目的是确定这是由于生产“更强”的片剂(每毫克片剂中含有更多的MDMA),还是片剂只是变得更大更重(片剂中含有更多的毫克)。设计/方法/方法分析了跨欧洲药物信息(TEDI)网络的10个成员在2012-2021年获得的31,716片摇头丸的数据集。研究结果摇头丸片中的MDMA质量分数在过去10年中几乎没有变化,MDMA含量的增加几乎完全归因于片剂重量的增加。这些趋势在整个欧洲似乎是一致的,尽管TEDI参与者使用了不同的采样和分析技术。研究还表明,虽然片剂重量与每年的MDMA含量完全相关,但MDMA质量分数的巨大变化使得这种关系与确定单个片剂的MDMA含量无关。研究局限性/意义这些结果为减少危害提供了新的机会,因为尺寸是一个有形的和明显准确的特征,强调一片不等于一次剂量。虽然这项研究的结果也表明,化学分析对于准确的个性化减少危害仍然至关重要,但这对于没有大量摇头丸内部定量资源的减少危害服务尤其有用。原创性/价值这些发现既新颖又相关,为跨国层面的摇头丸生产市场动态提供了新的见解。
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引用次数: 3
Who uses drug checking services? Assessing uptake and outcomes at English festivals in 2018 哪些人使用药物检查服务?评估2018年英语节的吸收和结果
Q4 SUBSTANCE ABUSE Pub Date : 2022-11-07 DOI: 10.1108/dhs-02-2022-0008
F. Measham, H. Simmons
PurposeThis study aims to assess service user characteristics, uptake and outcomes for drug checking services offered to over 250,000 English festival-goers in summer 2018 and to compare findings with earlier years, wider festival-goers and the general population.Design/methodology/approachA total of 2,672 substances of concern were submitted by the public and tested by chemists in mobile laboratories on 24 show days at seven festivals. Results were embedded in 2,043 individually tailored brief interventions (BI) delivered by health professionals to 4,240 service users. Comparative data were collected through anonymous self-report surveys with 1,291 respondents at five of the same festivals.FindingsThree percent of drug-using festival-goers received BI, 95% of whom had not previously accessed health services regarding their alcohol or other drug use. Drug checking service users were significantly more likely to be younger, male and past month polydrug users with a wider range of drugs consumed in the last month compared with the general festival population. For samples matching purchase intent, nearly half intended to reduce dosage, with younger and female service users significantly more likely to reduce dosage. For substances identified as other than expected, nearly two thirds disposed of them.Social implicationsFestivals are potential sites to deliver innovative health interventions and to monitor their outcomes, reduce the risk of poisoning and overdose, and facilitate access to follow-up support services.Originality/valueThis study suggests that there is value in event-based services that provide risk reduction communications directly to young adults engaged in higher risk drug use compared with wider event and general populations.
本研究旨在评估2018年夏季向25万多名英国节日观众提供的药物检查服务的服务用户特征、吸收情况和结果,并将研究结果与前几年、更广泛的节日观众和普通人群进行比较。设计/方法/方法共有2,672种值得关注的物质由公众提交,化学家在7个节日的24个展期在流动实验室进行了测试。结果被纳入由卫生专业人员向4,240名服务使用者提供的2,043项量身定制的简短干预措施(BI)。通过匿名自我报告调查,在五个相同的节日中收集了1291名受访者的比较数据。研究结果:3%的吸毒节日参与者接受了BI,其中95%的人以前没有因酒精或其他药物使用而接受过卫生服务。药物检查服务的使用者更可能是年轻人、男性和过去一个月服用多种药物的人,与一般节日人口相比,他们在过去一个月服用的药物范围更广。对于符合购买意图的样品,近一半的人打算减少剂量,年轻和女性服务用户明显更有可能减少剂量。对于被确定为与预期不同的物质,近三分之二的物质被处置。社会影响节日是提供创新卫生干预措施和监测其结果、减少中毒和过量用药风险以及促进获得后续支助服务的潜在场所。独创性/价值本研究表明,与更广泛的事件和一般人群相比,基于事件的服务可以直接向从事高风险药物使用的年轻人提供降低风险的沟通,这是有价值的。
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引用次数: 4
Drug use patterns, harm reduction strategies and use of drug checking services in boom festival patrons 毒品使用模式,减少危害的策略和使用毒品检查服务在繁荣的节日顾客
Q4 SUBSTANCE ABUSE Pub Date : 2022-11-03 DOI: 10.1108/dhs-01-2022-0004
Helena Valente, Daniel Martins, Marta Pinto, J. Fernandes, M. Barratt
PurposeRecent studies have shown that people who attend electronic dance music events and use drug checking services (DCS) are a predominantly white male, highly educated middle-class population. However, there is still a lack of data beyond sociodemographic characteristics that must be addressed. This paper aims to describe the drug use patterns and protective behavior strategies (PBS) used by testers and nontesters at Boom Festival 2018 and analyze the relationship between these behaviors and the decision to use the DCS.Design/methodology/approachThis is an exploratory research based on a cross-sectional design using baseline data collected at the Boom Festival from testers (N = 343) and nontesters (N = 115).FindingsNontesters presented, in general, slightly higher frequencies of use for most drugs, whereas testers tended to adopt PBS more frequently. Moreover, testers planned their drug use more often than nontesters and set more limits on the amount of drugs they used in one session. Both of these behaviors work as predictors for using the DCS.Practical implicationsOur data suggest that DCS might not be easily accessible to all people who use drugs, reaching almost exclusively highly educated people that already apply several harm reduction strategies. Actions should be taken to promote service accessibility.Originality/valueTo the best of the authors’ knowledge, this paper is the first to compare the demographics, drug use and PBS adoption of DCS users with nonusers who attended the same festival.
最近的研究表明,参加电子舞曲活动和使用药物检查服务(DCS)的人主要是受过高等教育的中产阶级白人男性。然而,除了必须解决的社会人口特征之外,仍然缺乏数据。本文旨在描述2018年Boom Festival上测试人员和非测试人员使用的药物使用模式和保护行为策略(PBS),并分析这些行为与使用DCS决策之间的关系。设计/方法/方法这是一项探索性研究,基于横断面设计,使用Boom Festival上从测试人员(N = 343)和非测试人员(N = 115)收集的基线数据。一般来说,非测试者对大多数药物的使用频率略高,而测试者倾向于更频繁地采用PBS。此外,测试者比非测试者更经常地计划他们的药物使用,并且对他们在一次测试中使用的药物数量设置了更多的限制。这两种行为都可以作为使用DCS的预测因素。实际意义我们的数据表明,并非所有吸毒者都能轻易获得药物控制,几乎只有受过高等教育、已经采用了几种减少危害策略的人才能获得药物控制。应采取行动促进服务的可及性。原创性/价值据作者所知,本文首次比较了参加同一节日的DCS用户与非用户的人口统计学、药物使用和PBS采用情况。
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引用次数: 2
Availability of different types of alcohol and amount of intake and next-day hangover – a naturalistic randomized controlled pilot trial 可获得的不同类型的酒精和摄入量和第二天的宿醉-一个自然的随机对照试验
Q4 SUBSTANCE ABUSE Pub Date : 2022-10-31 DOI: 10.1108/dhs-03-2022-0015
Ole Grummedal, Marie Strøm Zangenberg, J. Tolstrup
PurposeThe authors tested the hypothesis that having a high availability of different types of alcoholic drinks (beer, wine or spirits) as compared to being confined to one type only associate with a higher alcohol intake and worse next-day hangover.Design/methodology/approachThis randomized controlled pilot trial took place over one evening and included 35 individuals randomized into two groups. Individuals in the mixed-type group could consume any type of alcoholic drink (beer, wine, cocktails), whereas individuals in the single-type group were to adhere to one type of own choice. Information on number of drinks was obtained continuously during the trial. Hangover symptoms were reported by participants using the Acute Hangover Severity Scale (AHSS) at 8:00, 12:00 and 16:30 the following day. Median regression was used to assess number of drinks and maximum AHSS in two groups.FindingsParticipants in the mixed-type group consumed significantly more drinks compared to the single-type group (10.9 vs 5.7, p < 0.001). The maximal AHSS score the day after drinking was higher in the mixed-type group as compared to the single-type group (median 4.3 vs 2.6, p < 0.0001).Originality/valueThis study suggests that having a variety of alcoholic drinks available associates to a higher alcohol intake and more severe hangover as compared to having to adhere to one type only. Larger studies are warranted to validate findings.
目的:作者验证了这样一个假设:与只喝一种酒相比,多喝不同类型的酒精饮料(啤酒、葡萄酒或烈性酒)与高酒精摄入量和更严重的第二天宿醉有关。设计/方法/方法这项随机对照先导试验进行了一个晚上,将35名受试者随机分为两组。混合类型组中的个人可以饮用任何类型的酒精饮料(啤酒,葡萄酒,鸡尾酒),而单一类型组中的个人则坚持自己选择一种类型。在试验过程中,连续获得了饮酒量信息。参与者使用急性宿醉严重程度量表(AHSS)在第二天8:00、12:00和16:30报告宿醉症状。采用中位数回归评估两组的饮酒次数和最大AHSS。研究结果:与单一类型组相比,混合类型组的参与者消耗的饮料明显更多(10.9比5.7,p < 0.001)。与单一类型组相比,混合类型组在饮酒后一天的最大AHSS评分更高(中位数4.3 vs 2.6, p < 0.0001)。独创性/价值这项研究表明,与只喝一种酒相比,喝各种各样的酒精饮料会导致更高的酒精摄入量和更严重的宿醉。有必要进行更大规模的研究来验证研究结果。
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引用次数: 0
Drug checking in New Zealand: the 2020 and 2021 drug and substance checking legislation acts 新西兰的毒品检查:2020年和2021年毒品和物质检查立法法案
Q4 SUBSTANCE ABUSE Pub Date : 2022-10-11 DOI: 10.1108/dhs-03-2022-0016
F. Hutton
PurposeThis paper aims to explore the context and implications of the New Zealand Drug and Substance Drug Checking Acts 2020 and 2021.Design/methodology/approachThis discussion provides a description of legislative changes about drug checking in the New Zealand context, alongside a critical analysis of the interlinked factors surrounding these important pieces of legislation.FindingsThe legalisation of drug checking is an important harm reduction development in the New Zealand context, although overregulation of licensing requirements should be avoided, as well as overly punitive responses to peer service providers who may have criminal convictions. The new regulations should also ensure that innovation around new technology or products tested is not stifled.Originality/valueNew Zealand is the only country to introduce permanent national legislation to legalise drug checking, and as such analysis of the legislation is of interest to the international community.
本文旨在探讨2020年和2021年新西兰药物和物质药物检查法案的背景和影响。设计/方法/方法本讨论提供了新西兰背景下药物检查立法变化的描述,同时对围绕这些重要立法的相互关联因素进行了批判性分析。在新西兰,药物检查的合法化是一项重要的减少危害的发展,尽管应该避免对许可要求的过度监管,以及对可能有刑事定罪的同行服务提供者的过度惩罚性反应。新法规还应确保围绕新技术或测试产品的创新不被扼杀。新西兰是唯一一个引入永久性国家立法使毒品检查合法化的国家,因此对立法的分析是国际社会感兴趣的。
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引用次数: 2
What is drug checking, anyway? 什么是毒品检查?
Q4 SUBSTANCE ABUSE Pub Date : 2022-09-01 DOI: 10.1108/dhs-01-2022-0007
M. Barratt, F. Measham
PurposeThe recent influx of interest in and the changing status of drug checking has led us to reconsider some fundamental questions about drug checking. This commentary aims to define drug checking. It proceeds in three parts: terminology, definitions and programmes that are excluded from the definition of drug checking that still have value for harm reduction.Design/methodology/approachTo inform the commentary, an informal review of pertinent publications on the topic was conducted to extract relevant definitions and terminology.FindingsDrug checking services (DCS) have five necessary features: (1) aim of reducing harm; (2) analyse samples directly from the public; (3) return results to the service user; (4) involve information exchange between service user and DCS; and (5) conduct a tailored intervention with the service user. Variable features include the populations served, setting, analysis methods, immediacy of results, nature of intervention, levels of engagement with other stakeholder groups, funding models, legal status and staff skillsets. Programmes that are not DCS but have some similarities to DCS include non-publicly accessible testing of drugs as well as testing of bodily fluids where results may inform drug alerts.Originality/valueDrug checking remains a legally, politically and commercially sensitive health service. Reflecting on the history and evolution of drug checking, both as a term and as a harm reduction service, helps provide clarity in terms of what drug checking is and what it is not. This facilitates more effective framing of evaluations, in terms of what DCS aim to do and achieve.
目的近年来对药品检查的关注和现状的变化促使我们重新思考药品检查的一些基本问题。这篇评论的目的是定义药物检查。它分三个部分进行:术语、定义和方案,这些术语、定义和方案被排除在药物检查定义之外,但仍有减少危害的价值。设计/方法/方法为了使评注提供信息,对有关专题的出版物进行了非正式审查,以提取相关定义和术语。发现药品检查服务(DCS)具有五个必要特征:(1)以减少危害为目的;(二)直接分析公众采集的样本;(3)将结果返回给服务用户;(4)涉及服务用户与DCS之间的信息交换;(5)对服务用户进行量身定制的干预。可变特征包括服务人群、环境、分析方法、结果的即时性、干预的性质、与其他利益相关者群体的接触程度、筹资模式、法律地位和工作人员技能。不属于DCS但与DCS有某些相似之处的规划包括非公开获取的药物检测以及体液检测,其结果可通报药物警报。原创性/价值药物检查仍然是一项法律、政治和商业上敏感的医疗服务。反思药物检查的历史和演变,无论是作为一个术语还是作为一项减少危害的服务,都有助于明确药物检查是什么,不是什么。这有助于更有效地制定评估框架,就DCS的目标和实现而言。
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引用次数: 7
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