Vuto la opioid lidakali limodzi la mavuto aakulu kwambiri a zaumoyo wa anthu ku United States, likupha anthu zikwi makumi ambiri chaka chilichonse ndi kuvutitsa njira zosamalira thanzi, anthu, ndi mabanja. Pamene kuli kwakuti njira za boma zimapereka chitsogozo ndi ndalama, mizera yotsogolera ya mliriwu kaŵirikaŵiri imakhala pamlingo wa boma. Maboma alamulo ali ndi mphamvu yopanga malamulo ndi malamulo ndi kuukira kumene kumayambukira mwachindunji, kutsendereza, kusungitsa, ndi kuchepetsa. Pafupifupi zaka khumi zapitazo, boma lililonse lapanga mpambo wa ndalama zolinganizidwa kuletsa kugwiritsidwa ntchito molakwa kwa opioid, kuwonjezera njira zoyendera, ndi kutsutsa lamulo losakhala la lamulo. Zoyesayesa zimenezi nzamphamvu, ndi kutsutsa kuchepetsa imfa.

Kufikira Pamavuto a Malamulo

Malamulo akhazikitsa malamulo ayamba njira yothandiza kwambiri kuti athetse mliri wa opioid. Njira zogwira mtima kwambiri zophatikiza njira zaumoyo wa anthu ndi kusintha kwa chilungamo chaupandu, kuzindikira kuti kumwerekera ndi nthenda yovuta imene imafunikira zonse ziŵiri chisamaliro ndi malamulo olimba. Mbali zazikulu za kachitidwe ka malamulo zimaphatikizapo kufutukuka kwa mphamvu ya kuchiritsa, kutsendereza malamulo, kulimbitsa njira zosungitsa lamulo, ndi kusungitsa. Kufikira kwa boma lililonse kumasonyeza mkhalidwe wake wapadera wandale, zosoŵa za anthu, ndi ukulu wa vutolo mkati mwa malire ake.

Kukulitsa Njira Yochizira

Imodzi ya malamulo ovuta kwambiri a boma opioid ndiyo kuwonjezera kupezeka kwa mankhwala ogwirizana ndi umboni, makamaka mankhwala othandizira (MAM). MAME amaphatikiza mankhwala ovomerezedwa a FDA-FDA monga buprenorphine, metaharone, ndi naltrexone wokhala ndi malangizo ndi njira zothandizira. Maboma ambiri apereka malamulo oletsa odwala kulowa m’malo mwa njira zochiritsira moyo zimenezi. Mwachitsanzo, maboma angapo achotsapo zofunika pasadakhale paziyeso za MPUP ku Médicaid, kuwonjezera ndandanda ya zoperekera chithandizo chimene chingapereke ku buprenorphine (kuphatikizapo othandizira ndi othandizira achipatala) ndi owonjezera ndalama zowonjezera pa mapulogalamu a opieti.

Maboma agwiritsiranso ntchito nyumba zamakono kuti afikire kumidzi ndi kutsalira. Mliri wa Chovid-19 wawonjezera kugwiritsidwa ntchito kwa telemedicine kuti apeze mankhwala oledzeretsa, ndipo makhoma ambiri apanga kuti mapangano anthaŵi yochepa akhalepo. Malamulo tsopano amalola odwala kulandira malangizo a mankhwala a upernophine kudzera mwa maulendo enieni popanda kupenda koyamba. Kusintha kumeneku kwakhudza kwambiri maboma a m’madera akumidzi aakulu, monga Kentucky ndi West Virginia, kumene kusoŵa kwa zoyendera ndi zosungira katundu kuli zopinga zazikulu.

Ndiponso, maboma ena apanga makhoti apadera olera kapena maprogramu a opioid omwe amapatsira olakwa opanda chiwawa kuchipatala mmalo mwa kumangidwa. Makhoti ameneŵa kaŵirikaŵiri amalamula kuti atengemo mbali m'MATS ndi kupereka maulamuliro aakulu. Malamulo apereka ndalama zowonjezera mphamvu ya malo operekera chithandizo, malo othandizira opatsirako matenda, ndi zipatala zopimira. Mwachitsanzo, bungwe la okhazikitsa malamulo la Ohio linapereka chikalata cha malamulo cha ndalama zoyendera $30 miliyoni pomawonjezereka AMT kulowa m’ndende za m'dzikolo ndi m'zipatala zaumoyo.

Kulangiza Ana Kuti Azitsatira Malangizo

Chida chovomerezedwa kwambiri ndi opioid chinali kuyendetsa zinthu zazikulu za mliriwu. Poyankha, makhonsati a boma akhazikitsa malamulo osiyanasiyana oyenera kukhazikitsa. Chida chovomerezedwa kwambiri ndi anthu ambiri ndicho Precrimic Drug Monitoring Program (PDMP). Makompyuta amagetsi ameneŵa a magetsi oletsa mankhwala oletsa ndi operekera mankhwala osokoneza magazi ndi ogulitsa mankhwala osokoneza magazi omwe amalola odwalitsa kapena kulandira masungwe angozi a mankhwala. Mayiko ambiri tsopano amalamula kuti olamula olemba mankhwala a PDMP asanayambe kutulutsa mankhwala opaid oletsa kupweteka koopsa, ndipo ena amafuna kuti apereke mankhwala onse oyendetsedwa. Kulimbikitsa olemba malamulo a PDMPérobioted kuzungulira kwa mayiko onse, monga ogwirizana ndi operekera malamulo kuti apeze njira zoyendera mankhwala.

Kupyola PDMPs, maboma ambiri akhazikitsa malire pa kuchuluka ndi utali wa mankhwala oyambirira a opioid othandizira kupweteka kwakukulu. Mwachitsanzo, maboma ambiri amapatsa mankhwala anthaŵi yoyamba pa masiku asanu ndi aŵiri kapena khumi, ndi malire okhwima kwa ana. Malamulo ena amafuna kuti malamulo alembedwe kaamba ka mankhwala ochepetsa mphamvu ndi kuphatikizapo kukambitsirana za njira zina zosagwiritsidwa ntchito posapumirapo. Kupitiriza maphunziro a kuchiritsa ndi kupatsa mankhwala a masiku khumi ndi masiku khumi kuli chinthu china chofala kwa madokotala, mano, ndi olembera ena. Maboma angapo akhazikitsa malamulo amene afunikira ngakhale kuvomereza kuti odwala apereke chikalata chovomereza maupandu a opioid asanalandire.

Malamulo aperekanso malangizo a madipatimenti ndi njira zangozi, kumene mankhwala a opioid amalembedwa mobwerezabwereza. Mwachitsanzo, boma la Washington linakhazikitsa malamulo opangira mankhwala opasa ofunikira kugwiritsidwa ntchito pochitika mwadzidzidzi, kulimbikitsa kugwiritsira ntchito mankhwala oletsa ngozi ndi actaminophen polimbana ndi kupweteka kwakukulu. Njira zimenezi zachepetsa kwambiri kuchuluka kwa opioid prevition , ngakhale kuti mavuto adakalipo potsimikizira kuti odwala kupweteka kwanthaŵi yaitali adakali ndi kufunikira kuchiritsa.

Kukakamiza Lamulo ndi Chilungamo cha Mpandu

Pamene kuli kwakuti kuletsa ndi kuchiritsa kuli kofunika kwambiri, kusungidwa kwa lamulo kukukhalabe mbali yaikulu ya lamulo la boma lotchedwa opioid, makamaka polimbana ndi kuzembetsa phentanyl ndi kuŵerengera amalonda apamwamba. Maboma ambiri ali ndi chilango chowonjezereka cha kuzembetsa phentanyl ndi malamulo ake, nthaŵi zina zopereka zigamulo zocheperapo kaamba ka kukhala ndi unyinji wakutiwakuti. Malamulo ena anapanganso milandu yatsopano yogaŵa carfentil, wochiritsa nyama wamphamvu amene apezedwa m'kugulitsa mankhwala oletsedwa.

Panthaŵi imodzimodziyo, maboma ambiri avomereza masinthidwe a upandu amene amaika patsogolo kusungidwa kwa opalamula a mankhwala ogodomalitsa apamwamba. Makhoti a mankhwala, amene amagwirizanitsa uyang'aniro wachiweruzo ndi kupatsidwa kwa lamulo ndi kuyesedwa kwanthaŵi zonse kwa mankhwala, afutukulidwa kupyolera mwa ndalama ndi malamulo a boma. Maprogramu ameneŵa asonyezedwa kuchepetsa kudalirana kwa lamulo ndi kusunga ndalama za okhometsa msonkho. Kuwonjezerapo, maboma ambiri apereka malamulo abwino Asamariya omwe amapereka chitetezo cha ku kumangidwa kapena kuchitiridwa mlandu kwa anthu amene amaitanira 91111 kukapereka lipoti la kumwerekera ndi kugwiritsa ntchito konkitsa. Malamulo ameneŵa amalimbikitsa ofufuza chithandizo popanda kuopa kubwezera kwa lamulo, kupulumutsa miyoyo.

Naloxene malamulo ena aakulu oyendetsera malamulo. Naloxone (dzina la Narcan) ndi wotsatira wa mankhwala owonjezera mphamvu amene angabwezerenso kuchuluka kwa mankhwala ngati aperekedwa mofulumira. Boma lililonse tsopano lili ndi malamulo olola ogulitsa mankhwala kufalitsa naloxone popanda lamulo, ndipo ambiri awonjezera kufikira kwa oyankha oyambirira, masukulu, ndi mabungwe a anthu. Maboma ena amafuna kuti apolisi asungitse naloxone, ndi ena alola kuimirira malamulo kuti aliyense aigule pa fakitale. Pangano la Minnesoshas, linapereka lamulo mu 2023 limene linalola boma kuima ndi malamulo kaamba ka naloxene ndi kugaŵira ndalama kuti apereke malamulo auleredwe auleredwe aulere kwa anthu okwerawo. Kuyesayesaku kuwonjezera kumeneku kwa kupulumutsa mankhwalawa kwa anthu.

Njira Zothetsera Mavuto

M’zaka zaposachedwapa, mabwalo a boma asintha kwambiri njira zochepetsera njira zotetezera thanzi la anthu. Kuchepetsako kupweteka kumafuna kuchepetsa zotsatira zoipa za kugwiritsira ntchito mankhwala popanda kuchotsa. Kugaŵira kwa Naloxone ndi mwala wapakona, koma njira zina zikuphatikizapo maprogramu a drigne (SPSP), fentanyl stempting , ndi malo otetezera odyetsera. Mautumiki a Syringe amapereka zingwe za anthu amene amatopetsa mankhwala osokoneza bongo, kuchepetsa kufalitsa HIV ndi hepatitis C. Pambuyo pa zaka makumi angapo za mkangano, chiŵerengero chowonjezereka cha mayiko alola SSPSP ndi kuthandizira ntchito yawo, kuzindikira kuti amagwirizanitsa otenga mbali ndi chithandizo cha mankhwala ndi mautumiki ena. Popanga mapulogalamu ake, pomangitsanso, pokonzanso njira yopereka ndalama zoyenerera 20222 ndi kuwonjezera kumanga mayeso a kumikhalidwe a kumidzi.

Mabuku oyesera Fentanyl ayamba kugwiritsidwa ntchito pochepetsa zida za anthu. Mabungwe otsika mtengo ameneŵa amathandiza anthu kuyang'ana mankhwala awo kuti aone ngati alipo, amene amasanganizidwa ndi mankhwala a heroin ndi achinyengo. Mayiko ena achotsapo zitsulo zopimira ndi kulola kuti azigawidwa kudzera m'maprogramu a zaumoyo. Pa zaka 2024, maboma oposa 30 akhazikitsa malamulo ochotsa poyera masamu oyesera a mankhwala osokoneza bongo, kuwapanga kukhala alamulo kuti azigwiritsa ntchito ndi kukhala nawo. Masitepewa aang'onowa angapatse anthu mphamvu yosankha ndi kuteteza kuchuluka kwa matenda.

Mwinamwake njira yochititsa ngozi yotsutsana kwambiri ndiyo kukhazikitsa malo otetezera ogwiritsa ntchito mankhwala opitirira muyeso (odziŵikanso monga malo oyang'anira). Malo ameneŵa amapereka malo aukhondo kumene anthu angagwiritsire ntchito mankhwala operekedwa ndi dokotala, kuchepetsa upandu wa kufa ndi kufalitsa matenda opatsirana. Pamene kuli kwakuti palibe boma limene lalola malo otero monga 2024, Rhode Island inakhala yoyamba kuvomereza programu ya oyendetsa ndege mu 2021, ndi New York City kutsegulira malo aŵiri mu 2021 pansi pa kuyesayesa kwa dipatimenti ya zaumoyo yakwawo. Maboma angapo akukanganirana mwamphamvu ndi malingaliro ofananawo, oyendetsedwa ndi umboni wochokera ku maiko ena kuti malo ameneŵa amachepetsa ntchito ndi kuyendera malo a anthu odzifunira.

Kuyamba Kuphunzira ndi Kupeŵa

Malamulo a boma azindikira kuti kupita patsogolo kothandiza kumafuna kuletsa kugwiritsira ntchito molakwa mankhwala opioid isanayambe. Zoyesayesa zotetezera kaŵirikaŵiri zimasumika pa maphunziro a achichepere, kulangiza orser, ndi ndawala zodziŵitsa anthu. Maboma ambiri tsopano amalamula maphunziro a opioid m'masukulu, kuphunzitsa ophunzira za maupandu a kugwiritsira ntchito molakwa mankhwala oletsa ndi ngozi za fantanyl. Malamulo ena amafuna kuti maphunzirowo aphatikizepo chidziŵitso cha thanzi la maganizo, maluso, ndi njira zowakana. Mwachitsanzo, Indiana pa kampaniodio, adapereka chikalata mu 2023 chofuna kuti sukulu zonse zapakati ndi zapamwamba zitetezere za kugwiritsidwa ntchito molakwa kwa anthu onse.

Maphunziro apamwamba akhalanso chinthu chofunika kwambiri. Kuchokera pa maphunziro opitirizabe, maboma ena akhazikitsa malamulo ofuna kuti masukulu a zamankhwala ndi maprogramu osunga anthu ayambe kugwiritsa ntchito maphunziro a opioid kumbuyo kwa makalasi awo. Kuwonjezera apo, ndawala za boma za anthu onse zokhala ndi ndalama zothandizira anthu opangika. Nthaŵi zambiri ndalama zothandizira kuchepetsa manyazi ndi kupititsa patsogolo njira zochiritsira. Massachusetts ayamba pulogalamu ya kufalitsa achinyamata a zaka za 182435, kugogomezera kuopsa kwa mankhwala opeka ndi kupezeka kwa mankhwala achinyengo. Massachusetts

Malamulo ena otetezera ndiwo kuchotsa mankhwala otetezereka. Malamulo aperekedwa kukhazikitsa maprogramu okhalitsa oletsa mankhwala osokoneza bongo pa makampani, polisi, ndi zosonkhanitsa za anthu. Mayiko ena amafuna opanga mankhwala kuti apereke maprogramu, ndipo ena akhazikitsa malamulo olimbikitsa kugwiritsira ntchito zinthu zotayidwa m’nyumba. Kutaya zinthu zoyenera kumachepetsa kuthekera kwakuti mankhwala osagwiritsidwa ntchito adzapatutsidwa ku kusakhala kwamankhwala. Oregon adapanga mankhwala osokoneza bongo adziko lonselo kutenga programu yogwirizana kotheratu ndi opanga mankhwala osokoneza bongo, kupangitsa kuti akhale imodzi ya zofala kwambiri m'dzikolo.

Mavuto Amene Tikukumana Nawo M’tsogolo

Ngakhale kuti pali kupita patsogolo kwakukulu, mayiko akulimbana ndi mavuto oopsa. Stigma amapitirizabe kukhala chopinga champhamvu pa khalidwe lofuna chithandizo, kwa anthu onse omwe amagwiritsa ntchito mankhwala ndi kwa osamalira thanzi amene angazengereze kuvomereza MPM. Kupereka ndalama zothandizira anthu ambiri, ngakhale ngati ndalama zothandizira kulipira ndalama za mankhwala zikuyamba kulowa m'makhoti opanga mankhwala. Maboma ayenera kupatsa ndalama zimenezi mosamala kwambiri kuti apereke mapulogalamu ozikidwa pa mapulogalamu a zachipatala popanda kudalira pa mitsinje ya ndalama ya pa nthaŵi imodzi.

Kuchuluka kwa anthu olandira ndalama zothandizira anthu, komanso anthu a mitundu yosiyanasiyana, ngakhale kuti pali njira zambiri zothandizira anthu amene akudwala matendawa. Malamulo a boma ayenera kulankhula ndi anthu oletsa thanzi, monga nyumba, ntchito, ndi kutha kupeza chithandizo chachikulu, kuyambitsa mikhalidwe imene imachirikiza kuchira. Kuthandiza anthu amaganizo okhala ndi matenda osokoneza maganizo ndi kugwiritsa ntchito mankhwala osokoneza bongo n’kofunikanso, monga momwe anthu ambiri odwala matenda a maganizo amachitira ndi mikhalidwe yamaganizo yomwe imayambitsa. Mayiko angapo apereka malamulo oyenera kukonza mainshuwalansi kuti apeze chithandizo cha maganizo ndi kugwiritsa ntchito mankhwala olimbitsa thupi, koma amapitirizabe kugwiritsa ntchito.

Kuyang'ana kutsogolo, mabwalo a malamulo a boma angasumike pa nkhani zingapo zimene zikubuka. Kukwera kwa xylazine (mankhwala oletsa kugwiritsa ntchito mankhwala osokoneza bongo) kwayambitsa mavuto atsopano, chifukwa chakuti sikuyankha ku mabala aakulu. Maboma ena akuyesa malamulo oyesa ngati xylazine ndi kusamalira mabala, ndiponso kuwonjezera kuwonjezera chilango cha kugaŵira kwake. Kuwonjezera apo, kuzindikira kowonjezereka kwa akatswiri a ausinkhu wawo amene ali ndi chidziŵitso cha kumwerekera ndi kumwerekera ndi kumwerekera ndi kumwerekera ndi mankhwalawa kwa [1] kumachititsa kuti akhazike lamulo la ku index, sitima, ndi kuchirikiza antchito ameneŵa. Mayiko angafufuzenso kuwonjezereka kwa njira zoyendera njira zofunikira kugaŵira ma ma ma MP, monga ngati naxrepreena ndi brenover.

Chomalizira, kufunika kwa njira zokulirapo, zogwiritsira ntchito chidziŵitso sungatchulidwe mopambanitsa. Maboma ambiri akhazikitsa magulu kapena mabungwe ogwirizanitsa zoyesayesa kudutsa magulu ndi kulimbikitsa masinthidwe a malamulo. Kugwiritsiridwa ntchito kwa chidziŵitso chenicheni cha nthaŵi yeniyeni kuti adziŵe ziwopsezo zobuka ndi zipangizo zosungira zinthu kudzakhala kofunika kwambiri. Monga momwe mliriwo umayambira, moteronso lamulo la boma liyenera kukhazikitsa njira zotetezera, kuchiritsa, kuchepetsako, ndi kuchirikiza.

Kumaliza

Malamulo a boma ali ofunikira kwambiri poyankha vuto la opioid. Mwa kuphatikiza kufutukuka kwa mankhwala, malamulo, kukhazikitsa malamulo, kuchepetsa njira zowatetezera, ndi maprogramu oletsa, iwo apulumutsa miyoyo yosaŵerengeka ndi kuchepetsa mphamvu ya mliriwo. Ngakhale kuti palibe lamulo limodzi lomwe lingathetse vutolo, chiyambukiro chachikulu cha kuchuluka kwa umboni wozikidwa pa malamulo nchamphamvu. Kupitiriza kuyendetsa malonda, ndi kugwirizana ndi malamulo kudzakhala kofunika pamene mavuto atsopano atulukira. Mwa kuphunzira kupambana ndi kulephera kwa mapangano onse aŵiri, opanga lamulo angapange zomanga zaumoyo zolimba kwambiri zimene sizili ndi maadiresi opio komanso ziikanso maziko a maziko a kutsogolo kumene kumwerekera ndi kugwiritsa ntchito molakwaniridwa ndi kuyenera.

[[NTL: 0] Zopereka zowonjezereka: kaamba ka chidziŵitso chowonjezereka pa lamulo la boma lokhala pansi, chezerani [[FLT:] National Academy for State Health Policy (NASHP] opioid respoid re respoir . Zida za opioid kufa ndi njira zotetezera zimakhalapo kuchokera ku [[FLT:]]] Malo a Matenda a Kulamulira ndi Kuteteza (CDC) [FLT]. [FLT:] Kupotoza Kuzunza ndi Mautumiki a Zaumoyo (ASA) [FLT] [F] [5]