法律研究:对马萨诸塞州2018年《护理法》的定性研究,该法案扩大了急诊科对阿片类药物使用障碍药物的使用。

IF 3.7 2区 医学 Q1 PSYCHOLOGY, CLINICAL Journal of Substance Abuse Treatment Pub Date : 2022-10-01 DOI:10.1016/j.jsat.2022.108803
Rachel H. Alinsky , Catherine Silva , Hoover Adger , Emma E. McGinty
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引用次数: 0

摘要

背景:在急诊科(ED)就诊时启动阿片类药物使用障碍(mod)的药物治疗是一项重要的创新,可以让个体参与成瘾治疗。2018年,马萨诸塞州通过了《护理法案》(CARE Act),成为第一个立法规定拥有急诊科的医院必须能够提供mod的州。本研究以质性研究探讨政策制定的影响因素。方法在2019年对州政府、医院、医师专业协会和康复/行为健康组织等参与决策过程的10个关键利益相关者进行了半结构化访谈。使用混合归纳-演绎方法分析2020-2021年的数据。结果利益相关者表达的第一个关键主题是研究和公共卫生共识的重要性;他们描述了在现有联盟内就迫切需要采取行动达成的共识,并支持利用这一循证战略扩大治疗。第二,利益相关者讨论了通过预算中立立法和确保不同类型医院的灵活性来克服融资和可行性问题。最后,利益相关者展望了实施,描述了实施指南的发展过程,并确保在整个州存在持续治疗的能力。结论本研究表明,支持ED诱导的有效性的研究推动了国家立法的通过。与会者还认为,各利益攸关方之间为实现增加获得循证治疗以应对类阿片流行病这一共同目标而开展的长期合作有助于促进该法律的通过。其他州的政策制定者和倡导者可能会将马萨诸塞州的立法程序视为实施类似立法的典范,作为解决药物过量危机战略的一部分。
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Research to law: A qualitative study of Massachusetts' 2018 Care Act expanding emergency department initiation of medication for opioid use disorder

Background

Initiating medication for opioid use disorder (MOUD) during emergency department (ED) visits is an important innovation to engage individuals in addiction treatment. In 2018, Massachusetts passed the CARE Act, becoming the first state to legislate that hospitals with EDs must be able to offer MOUD. We performed a qualitative study to explore factors influencing policy enactment.

Methods

Semi-structured interviews were conducted in 2019 with ten key stakeholders involved in the policymaking process representing state government, hospitals, physician professional societies, and recovery/behavioral health organizations. Data were analyzed in 2020–2021 using a hybrid inductive-deductive approach.

Results

The first key theme stakeholders expressed was the importance of research and public health consensus; they described consensus building within existing coalitions regarding the pressing need for action, and supporting expansion of treatment with this evidence-based strategy. Second, stakeholders discussed overcoming financing and feasibility concerns by passing budget-neutral legislation and ensuring flexibility for diverse hospital types. Lastly, stakeholders looked towards implementation, describing the implementation guide development process and ensuring capacity for continuing treatment existed throughout the state.

Conclusions

This study suggests that research supporting the effectiveness of ED MOUD induction drove the passage of this state legislation. Long-term collaboration between diverse stakeholders towards a common goal of increasing access to evidence-based treatment to address the opioid epidemic was also perceived as facilitating the law's passage. Policymakers and advocates in other states may look towards Massachusetts's legislative process as a model for implementing similar legislation as part of their strategies to address the drug overdose crisis.

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来源期刊
CiteScore
7.60
自引率
10.30%
发文量
220
期刊介绍: The Journal of Substance Abuse Treatment (JSAT) features original reviews, training and educational articles, special commentary, and especially research articles that are meaningful to the treatment of alcohol, heroin, marijuana, and other drugs of dependence. JSAT is directed toward treatment practitioners from all disciplines (medicine, nursing, social work, psychology, and counseling) in both private and public sectors, including those involved in schools, health centers, community agencies, correctional facilities, and individual practices. The editors emphasize that JSAT articles should address techniques and treatment approaches that can be used directly by contemporary practitioners.
期刊最新文献
Not in my treatment center: Leadership's perception of barriers to MOUD adoption Peer support to reduce readmission in Medicaid-enrolled adults with substance use disorder National trends in buprenorphine prescribing before and during the COVID-19 pandemic A qualitative analysis of barriers to opioid agonist treatment for racial/ethnic minoritized populations An intervention pilot to facilitate harm reduction service decentralization in Vietnam
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