评估遏制美国医生阿片类药物处方行为的政策反应

IF 1.2 4区 法学 Q3 POLITICAL SCIENCE Public Administration and Policy-An Asia-Pacific Journal Pub Date : 2023-09-27 DOI:10.1108/pap-03-2023-0032
Roshni Das
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引用次数: 0

摘要

2017年,阿片类药物流行在美国被宣布为突发公共卫生事件。联邦政府和州政府仍在努力通过各种立法来控制危机,并遏制过量服用和死亡的浪潮。本文特别关注医生向患者发放阿片类药物的高处方问题。本文通过对学术文献、政府政策文件(州和国家层面)和大众媒体文章的批判性回顾和综合,评估了这一不断演变的政策问题。过度处方是一个法律问题,因为它不可避免地导致这些物质转移用于非医疗用途。所有50个州都通过了处方药监测计划(PDMP)法律,并涵盖了主要的政策回应。但是,它们的效力存在障碍,必须加以解决。讨论了两种州一级的政策选择作为潜在的解决方案- PDMP授权和疼痛管理诊所法(PMCLs)。经过比较评估,建议各州紧急通过强制性PDMP审查和使用法律。这是在更大的阿片类药物滥用问题中,对医生过度处方的具体和时间敏感方面的第一个详细的政策评估。此外,对公共卫生领导问题提出了批评。
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Evaluating the policy response to curb the opioid prescribing behaviour of physicians in the United States
Purpose In 2017, the opioid epidemic was declared a public health emergency in the United States. The federal and state governments are still struggling to contain the crisis through various legislations and to stem the tide of overdoses and deaths. This paper looks specifically at the issue of high prescriptions of opioids disbursed to patients by physicians. Design/methodology/approach This paper evaluates this evolving policy issue through a critical review and synthesis of academic literature, government policy documents (at states and national levels) and articles in the popular press. Findings Over-prescription is a legal problem because it inevitably leads to diversion of these substances for non-medical usage. The Prescription Drug Monitoring Program (PDMP) laws have been passed by all 50 states and the main policy responses are covered. However, there are hindrances to their effectiveness, which have to be addressed. Two state level policy alternatives are discussed as potential solutions — PDMP mandates and Pain Management Clinic Laws (PMCLs). After a comparative evaluation, it is recommended that all states should pass the mandatory PDMP review and usage laws urgently. Originality/value This is the first detailed policy evaluation on the specific and time-sensitive aspect of physician over-prescribing, within the larger opioid abuse problem. Moreover, critique on the public health leadership issue is raised.
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来源期刊
CiteScore
2.50
自引率
7.10%
发文量
30
审稿时长
8 weeks
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