Vuto la Opioid ndi Udindo Waukulu wa Boma

Mliri wa opioid udakali umodzi wa ngozi zaumoyo wa anthu zosakaza kwambiri m'mbiri yamakono ya Amereka, ukumatchula zaka makumi zikwi za miyoyo pachaka ndi kusokoneza madongosolo a zaumoyo, kusungitsa malamulo, ndi madera. Pamene kuli kwakuti mabungwe a boma amapereka zitsogozo za ndalama ndi zitsogozo, zigamulo zokulira, maulamuliro a boma. Maulamuliro a boma . (_governors, akazembe, ndi akuluakulu a zaumoyo) a ulamuliro wa kulinganiza malamulo amene amayambukira mwachindunji, kuchepetsa, kuvulaza, ndi kutsata lamulo. Zosankha zawo zimatsimikizira mmene zikwanitsirizo zimalembedwera bwino ndi kukakamiza, ndi mmene umboni woperekedwa mwamsanga ukhoza kufikiritsa anthu osoŵa.

Nkhani ino ikupenda ntchito yofunika kwambiri ya mabwana a boma posamalira vuto la opioid, njira zazikulu zimene amagwiritsira ntchito, zopinga zimene amayang'anizana nazo, ndi zitsanzo zenizeni za dziko za njira zachipambano za boma. Mwakumvetsetsa maluso amphamvu ameneŵa, osungitsa, angachirikize bwino ndi kugwiritsa ntchito malamulo amene amapulumutsa miyoyo ndi kuchepetsa chiyambukiro cha nthaŵi yaitali cha mliriwo.

Ntchito ya Boma Polimbana ndi Mliri wa Opioid

Akuluakulu a boma ali ndi malo apadera ogwirizanitsa mayankhidwe a madipatimenti a zaumoyo, maofesi a Medicaid, mankhwala ogwiritsira ntchito njira zochiritsira matenda, mabungwe osungitsa lamulo, ndi madongosolo a maphunziro. Amakhazikitsa njira za mmene maboma awo amachitira ndi kumwerekera . Kaya ndi nkhani ya chigamulo chaupandu, vuto laumoyo wa anthu, kapena kuphatikiza zonse ziŵiri. Malamulo awo, kulinganiza a bajeti, ndi maprogramu a malamulo angafulumize kapena kulepheretsa kugwiritsira ntchito njira zotsimikizirika.

Mwachitsanzo, akazembe ali ndi mphamvu zolengeza za vuto la zaumoyo wa anthu, limene lingatulutse ofewa ndi oletsa kugwiritsa ntchito. Iwo angaikenso magulu a ntchito, kutsogolera mabungwe a boma kuti akonzere kugawirana mankhwala a naloxone, ndi kukambirana ndi anthu athanzi kuti achotse zopinga za mankhwala othandizira kuchipatala (AMT). Attorney, pakali pano, kaŵirikaŵiri amatsogolera mayiko ambiri polimbana ndi opanga mankhwala ndi otulutsa makampani, kukonzanso madola mamiliyoni ambiri amene angapereke ndalama zothandizira kugwiritsa ntchito kumwerekera ndi mankhwala osokoneza bongo. Oyang'anira zaumoyo amayang'anira ntchito yoyang'anira ntchito yoyang’anira mankhwala (PMPS) ndi masamu a zapamwamba a zojambula zimene za opanga mankhwala ojambula.

Chifukwa chakuti vuto la opioid limasintha mofulumira — kuchokera ku mankhwala oupioids kufika ku heroin kufika ku fentanyl ndipo tsopano kufikira ku maxylazine aunesitests . Mabwana a boma ayenera kusinthira njira zawo nthaŵi zonse. Utsogoleri wawo ngwofunika kuti apitirizebe kuchirikiza ndi kutsimikizira kuti malamulowo amagwirizana ndi umboni waposachedwapa ndi ziwopsyezo zimene zikubuka.

Malamulo Ofunika Ogwiritsiridwa Ntchito ndi Atsogoleri a Boma

Akuluakulu a boma achita njira zosiyanasiyana zochepetsera kugwiritsa ntchito mankhwala owonjezera mphamvu, kuchepetsa kugwiritsa ntchito mankhwala oledzeretsa, ndi kuwonjezera njira zowasamalira.

Kupeza Njira Zochizira ndi Kuchira Kofuna Mankhwala

Chimodzi cha zipangizo zothandiza kwambiri polimbana ndi opioid yogwiritsira ntchito matenda (OUD) ndi mankhwala othandizira kuchiritsa. Maboma ambiri awonjezeranso Medicaid pansi pa Affordable Care Act, popereka chilolezo cha kugwiritsa ntchito mankhwala osokoneza bongo kwa anthu achikulire otsika. Ofufuza apeza kuti ndalama zothandizira kugwiritsa ntchito ndalama za MPUT zikuwonjezeka kwambiri.

Akuluakulu a boma athandizanso kuchotsa zopinga za kukonza. Mwachitsanzo, ena aletsa lamulo lokhudza munthu wina kuti apereke kachipangizo ka mtundu wa budrenorphine (wotchedwa "X-waiserr"), sitepe imene pambuyo pake inapangidwa ndi boma. Ena adzipereka ku mautumiki a telehealth, kulola odwala m’madera akumidzi kuti apeze akatswiri ogwiritsa ntchito mankhwala osokoneza bongo. Kuwonjezera apo, akazembe alimbikitsa "hub-al-ping - disor" zitsanzo, kumene malo othandizira anthu ogwiritsa ntchito mankhwala osokoneza bongo (a hyps) amayendera limodzi ndi mautumiki aakulu osamalira anthu.

Kugwiritsa Ntchito Mapulogalamu Ophunzitsa Kugwiritsa Ntchito Mankhwala Osokoneza Bongo (PDMPs)

Ma PDMP ndi makompyuta a magetsi a mlingo wapamwamba amene amagwiritsira ntchito mankhwala oyendetsedwa. Akagwiritsidwa ntchito bwino, amathandiza madokotala kudziŵa odwala amene angakhale akuwakonza kapena kulandira maopioid ndi benzodiazepine. Mabwana a boma alimbitsa PDMP ndi kutumiza mafunso owonjezera, kuphatikiza chidziŵitso ndi zolembedwa za za zaumoyo zamagetsi, ndi kupanga madongosolo ogwirizana kudutsa mizera ya boma. Mayiko ena afunanso kuti apeze ma PDMP asanayambe kulembedwa kuti amve ululu woopsa (m.g.

Mabwana a boma agwiritsanso ntchito mfundo za PDMP potumiza mapilo a ma pulojekiti apamwamba, kutumiza malipoti a overageoid, ndi kudziŵikitsa anthu amene ali pamwambapa ndi kutumiza ndalama zofunikira kuchipatala. Komabe, mavuto akupitirizabe kutsimikizira kuti ma PDMP ndi mabwenzi a anthu ogwiritsa ntchito, ofika paubwenzi, ndipo osati olemetsa kwambiri kwa madokotala a pachipatala.

Kuchirikiza Njira Zochepetsera Mavuto

Machenjera ochepetsa mavuto afala kwambiri monga mbali yaikulu ya kuyankha kwa opioid. Maulamuliro a boma achita mbali yaikulu m'kufutukula njira ya naloxone, mankhwala opulumutsa moyo amene amasintha opioids. Ambiri apereka malamulo oimirira olola ma ma phymacone kufalitsa naloxone popanda pepala lopatsa ndalama, maprogramu operekedwa ndi anthu ochirikiza naloxone, ndi ophunzitsa anthu ndi ziŵalo za banja kugwiritsa ntchito ntchito ntchito ntchito.

Mayiko ena achitaponso zambiri pokhazikitsa mapulogalamu a jekeseni (SSPS), amene amapereka jekeseni yopatsa tizilombo, kuchepetsa HIV ndi matenda a hepatitis C, ndi kupereka mipata yolumikiza anthu ndi mankhwala. Maboma angapo ayendetsanso malo oyendera, kumene anthu angagwiritsire ntchito mankhwala osokoneza bongo moyang'aniridwa ndi madokotala kuti apeŵe kumwa mankhwala oopsa. Pamene kuli kwakuti zoyesayesa zimenezi zikukhalabe zotsutsana ndi ndale zadziko, akuluakulu a boma m'malo onga Rhode Island, New York, ndi California awapitikitsa patsogolo monga njira zothandizira zaumoyo wa anthu onse.

Kusintha Zinthu ndi Chiweruziro cha Apandu

Akuluakulu a boma amalimbikitsa malamulo amene angasinthe mmene milandu yokhudzana ndi kumwerekera imaimbidwa mlandu ndi mmene anthu amachitidwira m'dongosolo la milandu yaupandu. Olamulira angapo asaina "Musamariya wabwino" malamulo amene amapatsa anthu opangika ufulu wochepa kuti asapereke mlandu pa 911 panthaŵi ya kumwa kwambiri. Ena achirikiza "360-degree" maprogramu amene amapatsira olakwa a mankhwala osokoneza bongo mmalo mwa kuwatsekera kundende.

Kuwonjezera apo, akuluakulu a boma ayesetsa kusintha malamulo, monga kuchepetsa utali ndi kuchepetsa mankhwala opioid oyambirira a kupweteka kwakukulu. Mayiko ambiri tsopano amafuna kuti azipereka njira zina zothandizira kupweteka ndi kukambirana ndi odwala. Panthaŵi imodzimodziyo, maloya aakulu atsatira malamulo, kuphatikizapo maloboti a Johnson & Johnson ndi a dictributers, amene akupereka ndalama za mautumiki ogwiritsa ntchito mankhwalawa.

Mavuto Oyang’anizana Nawo Oyang’anizana ndi Boma

Ngakhale kuti amayesetsa kwambiri, atsogoleri a boma amalimbana ndi mavuto aakulu amene amasokoneza nkhondo yolimbana ndi vutoli.

Kuchepetsa ndi Kupereka Ndalama Zosadziŵika

Malo ambiri othandizira opioid amachokera ku ndalama za boma, monga ngati State Opioid Response (SOR) yoperekedwa ndi SAMHSA. Komabe, ndalama zimenezi kaŵirikaŵiri zimaikidwa ndi nthaŵi ndi kugawidwa ndi masinthidwe andale. Maulamuliro a boma ayeneranso kupikisana ndi zinthu zina zofunika kwambiri . Kuphunzitsa zinthu zofunika, zithandizo, kuvuta kusungitsa ndalama zanthaŵi yaitali ndi njira zothandizira chithandizo. Makipeyiwa amachotsedwa kwa zaka zambiri ndipo angabwere ndi ziletso zimene zingaperekedwe mwamsanga.

Kutsutsa Koipa ndi Zandale

Kumwerekera kudakali koluluzika kwambiri, ndipo akuluakulu ambiri a boma amalephera pamene anena kuti achepetse njira zovulaza monga SSP kapena malo oyendera. Chitsutso cha anthu a m’deralo, kusungitsa lamulo, ndi kuchedwa kugwiritsidwa ntchito. Ngakhale kuwonjezeka kwa machiritso ozikidwa pa umboni kungawonedwa ngati "kutchova" kugwiritsira ntchito mankhwala ndi mbali za anthu, kukakamiza atsogoleri a boma kugwiritsa ntchito kwambiri ntchito maphunziro a boma.

Kulinganiza Thanzi la Anthu Onse ndi Kukakamiza Lamulo

Akuluakulu a boma ayenera kusamala kwambiri za vuto la kugwiritsa ntchito mankhwala osokoneza bongo monga vuto la thanzi ndi kuchepetsa njira zopezera chithandizo mopambanitsa zingaletse anthu kufuna thandizo, pamene kuli kwakuti malamulo olekerera angaonedwe kukhala osathandiza mopambanitsa kwa ogulitsa. Kupeza kulinganiza kwabwino nkovuta, makamaka m’maiko okhala ndi chuma chochepa ndi mlingo waukulu wa upandu wachiwawa wokhudzana ndi misika ya mankhwala osokoneza bongo.

Kugwirizana kwa Zikalata ndi Kugwirizana

Malamulo achinsinsi monga HiPAA angaletsenso kugawana chidziŵitso. Mabungwe a boma afunikira kuphatikizapo mfundo zaumoyo ndi kugwirizanitsa chidziŵitso cha zaumoyo ndi kutumiza chidziŵitso cha zinthu zina kuti zidziŵike ndi kutulukira mavuto amene akubuka (m’mphindi, malamulo achinsinsi monga HiPAA angaletsenso kugawana. Maulamuliro a boma afunikira kusungitsa ndalama zothandizira kudziŵa zaumoyo ndi kugwirizanitsa chidziŵitso cha njira ndi kudziŵitsa zinthu zotsa ndi kutulukira mavuto obuka (m., zingwe, malamulo a m'kufa kwa phentinyl).

Kumidzi ndi Matauni

Vuto la opioid limayambukira ponse paŵiri midzi ya m’mizinda ndi ya kumidzi, koma mavuto amasiyana. Malo a m’matauni kaŵirikaŵiri alibe operekera chithandizo chomgoneka, kulibe mautumiki ochepetsako kuchuluka kwa makampani, ndi zoyendera za anthu onse kupita ku malo a ku malo. M’madera a m’matauni muli kuchuluka kwa mafanyo ndi mankhwala opanga, komanso kusowa pokhala ndiponso matenda a maganizo. Akuluakulu a boma ayenera kulinganiza malamulo ogwirizana ndi njira zosiyanasiyana zimenezi.

Kugonjetsa Mavuto mwa Kukonzanso Zinthu ndi Kulimbikira

Ngakhale kuti pali zopinga zimenezi, akuluakulu ambiri a boma asonyeza luso lodabwitsa ndi kutsimikiza mtima. Apanga mapepala opanga zinthu za chigawo chakunja kuti agwirizane ndi machitachita abwino, ogwirizana ndi zinthu zosapindulitsa monga gulu la National Guardinal Association, ndi kuloŵerera mwachindunji ndi anthu okhudzidwa ndi kumwerekera. Ena asankha "opidoid jastrial" kugwirizanitsa ntchito yothandiza anthu a m'mabungwe ndi kutsimikizira kuti ndalama zikugwiritsidwa ntchito bwino.

Zipangizo zamakono zimaperekanso njira zatsopano zothandizira anthu. Maboma ambiri akugwiritsa ntchito makina podziwa kuti awononga kwambiri mahomoni otentha ndiponso kufalitsa zinthu zina. Ena atumiza mapulogalamu a m’manja amene amagwirizanitsa anthu ndi malo othandizira odwala panthaŵi yeniyeni.

Kufufuza za Maupandu: Kuyamba Kutsatira Malamulo a Boma

Kupenda maboma apadera kumapereka maphunziro ofunika a zimene zimagwira ntchito, ndi zimene sizimachitidwa ndi mlingo wa opioid.

Ohio: Kulabadira Kogwirizana ndi Mawu a Mulungu

Ohio yakhala itayamba pa vuto la opioid , ndi kuchulukitsa kwa imfa pakati pa madipatimenti angozi. Poyankha, Kazembe Mike DeWine anatulutsa "Ohio Opioid Refection" mu 2019, akuphatikizapo $200 miliyoni kuchokera ku bajeti ya boma ndi ndalama zothandizira. Zofunika zimaphatikizapo kuwonjezera kufika kwa ma buprephoine m'madipatimenti angozi, kuchirikiza mayunivesiti a zaumoyo amene akufika kumidzi a Appália, ndi kupanga malo aakulu "opid preadboard" kuti afe, mapepala, ndi ntchito yopereka chithandizo. Boma loperekedwanso mokulira m'malamulo ndi operekedwa ndi lamulo la lamulo la kutchula anthu kuchiritsa m’malo mwa ndende. Monga chotulukapo, imfa ya ku Ohiokietiose mu 2022, ndi 202, ndi 2022, poyerekezera ndi kulongosola kulongosola kwa zaka za kuyambika kwa masamu, 202.

Rhode Island: Kuwononga Zinthu ndi Kuchiritsa

Rhode Island wachitapo kanthu molimba mtima mwa kugwirizanitsa kuchepa kwa zivulazo ndi dongosolo lake la zaumoyo. Pansi pa Bwana Rainondo ndi Bwanamkubwa Dan McKee, boma linachirikiza woyendetsa ndege waupainiya pamalopo . Woyamba m'dzikolo . ndi kuwonjezera maprogramu ake a ntchito ya jekeseni kuti aphatikitse zitsulo ndi zilonda. Rhode Island adagwiritsiranso ntchito njira ya kuchiritsa "hub ndi kulankhula" imene inawonjezera kwambiri chiŵerengero cha anthu olandira MPANDIKO. Pofika 2023, boma linasimba kutsika kwa 12% ya kuchuluka kwa mabomba owonjezereka poyerekezera ndi chaka chathawa.

Kumadzulo kwa Virginia: Kugonjetsa Zipilala za Kumidzi

Virginia wa West Virginia ali ndi chiŵerengero chapamwamba koposa cha imfa za opioid oread percents m'dzikolo, koma akuluakulu a boma achitapo kanthu mwamphamvu kuti athetse mipata ya kumidzi. Bwanamkubwa Jim Justice anafutukula programu ya boma ya Medicaid kukwaniritsa MPEND ndi kugwiritsira ntchito boma kupereka ndalama kupanga "magulu a anthu oyankha mwachangu" amene amachezera opulumuka ochulukitsitsa m'nyumba zawo. Bomalo layambitsanso pulatifomu ya chigawo cha chigawo chakumidzi imene imagwirizanitsa anthu akumidzi ndi akatswiri omwerekera ku West Virginia. Pamene kuli kwakuti mavutowo apitirizabe, njirazo zathandiza kuchepetsa ziŵerengero za imfa ndi kuchuluka kwa olandira chithandizo kwa zaka 15% m'zaka ziŵiri.

Malamulo a Mtsogolo a Ntchito ya Boma

Vuto la opioid likupitirizabe kusintha, pamene mapilisi achinyengo ophatikizapo pentanyl, xylazine (mankhwala ochepetsa ululu), ndi kugwiritsidwa ntchito kwa mankhwala opha tizilombo. Mabwana a boma ayenera kukhala patsogolo pa zochitika zimenezi. Zinthu zofunika m’tsogolo ziyenera kuphatikizapo:

  • Kutulukira m'madongosolo enieni oyendera nthaŵi amene angaone zinthu zimene zikutuluka ndi kuyambitsa tcheru ya thanzi la anthu.
  • Kukonza njira zothandizira kuchepetsa mphamvu ya mankhwala (mankhwala ochirikizidwa ndi mankhwala apakati) kuti adzutse ndi kugwiritsa ntchito polysubstries, kochirikizidwa ndi kufufuza kosonyeza kuti imagwira ntchito.
  • Kukulitsa antchito omwerekera mwa kugwiritsa ntchito ndalama pophunzitsa akatswiri ochiritsa ausinkhu wawo, ochiritsa, ndi othandiza achipatala kuti apereke MPEND.
  • Kufufuza kwapadziko lonse kwa mankhwala osokoneza kwambiri, madipatimenti a zamwadzidzidzi, ndi zipatala zapasadakhale.
  • Kulimbitsa mgwirizano wa chigawo cha chigawo pa kuyang'anira kwa boma ndi kusungitsa malamulo kugawana kusokoneza ntchito za kugulitsa mankhwala.

Olamulira ndi magulu awo ayenera kupitirizabe kumanga midzi yalamulo yopatulidwa, yanthaŵi yaitali yopereka ndalama kaamba ka mautumiki omwerekera . Kuletsa ndalamazo kuloŵetsedwa m'ma bajeti a anthu onse. Ndawala za maphunziro apoyera zimene zimapanga kumwerekera kwa anthu ndi kuchepetsa kunyazitsa zisungiko za anthu onse zidakali zofunika kuchirikiza.

Kumaliza

Akuluakulu a boma ndiwo mayankhidwe a opioid a ku America. Ulamuliro wawo pa madongosolo a zaumoyo, ma bajeti, ndi malamulo amawapatsa mphamvu yapadera yotembenuza umboni m'ntchito, kupulumutsa miyoyo, ndi kuchepetsa kuwonongeka kwa kakhalidwe ndi chuma kochititsidwa ndi kumwerekera. Pamene kuli kwakuti mavuto onga ngati kuchepetsa ndalama, manyazi, ndi chitsutso cha ndale zadziko akupitirizabe, utsogoleri watsopano ndi wotsimikiza wosonyezedwa m'maboma onga Ohio, Rhode Island, ndi West Virginia amasonyeza kuti kupita patsogolo nkotheka.

Pamene mliriwo ukusintha, kudzipereka kosalekeza kwa akuluakulu a boma kwa makampani a boma, mabungwe a kumaloko, ndi osamalira zaumoyo, kudzakhala kofunika. Cholinga chake sichili kungochepetsa imfa zopambanitsa, koma kukhazikitsa dongosolo lakuya, lachifundo, ndi lolimba limene limaletsa kumwerekera ndi kuchirikiza kuchira kwa Aamereka onse.

Kaamba ka chidziŵitso chowonjezereka, onani [[FLT: 0] CD's National Drug Overdose Surveillance [[FLT :1], Bwanamlungu As Association Opioid Initititive , ndi [FLT ,4] NPR yotsatira ndalama za boma zothandizira anthu [.