Dambudziko Rezvipembenene Nebasa Rehurumende Rine Simba

Denda reOpioid rinoramba riri imwe yemigariro yengozi yavose inoparadza zvikurusa munhau yazvino uno yeAmerica, richitaura makumi ezviuru zvoupenyu gore negore uye richidzvinyirira gadziriro dzezvoutano, kuchengetwa kwomutemo, uye nzanga. Nepo masangano ehurumende achigovera mari nenhungamiro dzakafara, mitsetse yemhinduro inodzorwa nehurumende. Vakuru vakuru vehurumende (/governor), vatongi vehurumende, magweta, uye vakuru vakuru vakuru vezvoutano vanodzora kuumba mitemo inotapura zvakananga kuiswa kwadziri, kubatwa kwapazadzwa, kukuvadzwa, kukuvadzwa, uye kuchengetwa kwomutemo. Zvisarudzo zvavo zvinosarudza kuti zvizvishandisiro zvinodzo zvinodzorwa zvinobudirira sei, kuti zvigove zvakatendwa sei, uye kuti kupindira kwoufakazi kunowirirana nokukurumidza kunosvika sei avo vanoshaiwa.

Nyaya ino inonzvera basa rinokosha rinoitwa navakuru vakuru vehurumende mukubata nenjodzi yeopioid, unyanzvi hunokosha hwemiitiro yavanoshandisa, mhinganidzo dzavanotarisana nadzo, uye mienzaniso chaiyoiyo yenyika yezviito zvehurumende zvinobudirira. Kupfurikidza nokunzwisisa aya masimba, vachengeti vemiitiro vanogona kutsigira zviri nani ndokushandisa mitemo inoponesa upenyu ndokuderedza tapuro refu yenguva yedenda racho.

Basa Revatungamiriri Vehurumende Mukurwisa Denda reOpioid

Vakuru vakuru vehurumende vane nzvimbo yechienzi yokubatanidza zviito zvemipimo yakawanda izvo zvinobatanidza mahofisi outano, Medicaid, mishonga inoshandisa gadziriro dzehosha, masangano anodzikamisa mutemo, uye gadziriro dzedzidzo. Vanoratidza nzira yokuti hurumende dzavo dzinosvika nayo kupindwa muropa nejeko-pfuundei (zvingava senhau yedare retsotsi, denho youtano yavose, kana kuti mubatanidzwa wezvose zviri zviviri. zvikarakadzo zvavo zvehurumende, bhajeti, uye miganhuro yemitemo zvinogona kukurumidzisa kana kuti kudzivisa kushandiswa kwemazano akatenderwa.

Somuenzaniso, magavhuna ane simba rokuzivisa njodzi yeutano yavose, inogona kutanga kuchinjika uye kupfuudza. Vanogonawo kugadza masimba ebasa, kutungamirira masangano ehurumende kuti aise kugoverwa kwenaloxone, uye kutaurirana nevezveutano kuti vabvise mhinganidzo dzokurapa kwemishonga (M). Attorneys, panguva ino, kazhinji kazhinji, dzinotungamirira kupiwa kwemichina yakawanda mukurwisana nemishonga uye varapi, kubvisa mabhirioni emadhora anogona kutsigira mabasa okupindwa muropa. Mabhirikota ezverwa ezvoutano anotarisira zvirongwa zvokuongorora mishonga (PDMPS) zvinotenderwa kurapa (PMP) uye madata anoona nezvemiitiro anoitwa nemishonga yapamberi.

Nemhaka yokuti njodzi yeopioid inochinja nokukurumidza — kubva mumaopioid anonyorwa nachiremba kusvikira kuheroin kusvikira kupentanyl uye zvino kusvikira kuxylazine allerants .ggyamazano ehurumende anofanira kugadziridza mitoo yavo nguva dzose. Utungamiriri hwavo hunokosha nokuda kwokuchengeta simba nokuva nechokwadi chokuti mitemo inoramba ichiwirirana noufakazi hwazvino uno netyisidziro dzinomuka.

Mitemo Inokosha Inoshandiswa Nevatungamiriri Vehurumende

Vakuru vakuru vehurumende vakaita nzira dzakawanda dzokuderedza kushandiswa kweopioid, kudzivisa kunyanyisa, uye kuwedzera nzira yokuwana nayo tarisiro.

Kuwedzera Kuwana Kurapa Nokupora Kunokonzerwa Nemishonga

Chimwe chezvishandiso zvinoshanda zvikurusa zvinodzivisa vhiringidziko yokushandisa mishonga (OUD) kurapa kunobatsira. Magavhuna akawanda akaisa panzvimbo yakakwirira simba reMATS kupfurikidza nokuwedzera mari yezvikamu zvekiriniki, achideredza zvinodikanwa zvokubvumirwa, uye achitsigira magiramu anofambisa mishonga. Masangano akawanda akakudzawo Mdhicaid pasi peAffordable Care Act, achigovera kuiswa kwekupindwa muropa nemunhu mukuru anowana. Kunzvera kunoratidza kuti Médiid akaona kuwedzera kwemitengo yemari yakatanhamara mukushandisa MPTS uye kuderedza marapidhiki.

Vakuru vakuru vehurumende vakashandawo kubvisa mhinganidzo dzinodzorwa. Somuenzaniso, vamwe vakadzivisa chinodikanwa nokuda kwomurairi akaparadzana kunyora budrenorphine (inonzi "X-waiser"), nhanho gare gare yakaratidzirwa nemitemo yehurumende. Vamwe vakaisa mibato yetelehealth, kubvumira varwere vari munharaunda dzomumaruwa kuwana nyanzvi dzokupindwa muropa nezvinodhaka kure. Mukuwedzera, magavhuna akatsigira "hub-apy-ping" mifananidzo, apo nzvimbo dzokurapa chaidzo dzinoshandiswa kupindwa muropa nezvinoiswa muropa nako zvinowirirana nezviwiriranwa zvikuru (vab) zvinobatanidza zvirairiso zvokutarisira zvinopfuurira.

Kushandisa Drug Monitoring Programs (PDMPs)

PDMP imapepa emagetsi enzvimbo yapakati penyika ayo anonzvera mishonga inodzorwa. Paanoshandiswa nenzira inobudirira, vanobatsira vanachiremba kuziva varwere vangave vari kurongedzerwa kana kuti kugamuchira mubatanidzwa une ngozi weopioids nebenzodizepines. Vakuru vakuru vehurumende vakasimbisa PDMP nemiraudzo inodzorwa necherekedzo, kubatanidza mashoko nezvinyorwa zvezveutano zvemagetsi, uye kuita kuti gadziriro dzinofambidzana dziyambuke mitsetse yehurumende. Dzimwe nyika dzakadawo kuti PDMPs dzinzverwe pamberi pokunyora opioids nokuda kwokurwadziwa kwakakomba (g., pashure pemiitiro yemazino) kuderedza ngozi yokushandisa zvisina kufanira muviri.

Vakuru vakuru vehurumende vanoshandisawo mashoko ePDMP kunyokera vanyori vePDMP vakakwirira, kutumira mishumo yetsigiri, uye kuziva nzanga dzine nhamba dzinopiwa pamusoro pezvirongwa zvokupindira kwechitsotsi. Zvisinei, zvinetso zvinoramba zviripo mukuvimbisa kuti PDMP ishamwari yeshamwari, inodzorwa neyakakwirira, uye hairemi zvikuru nokuda kwevana vekiriniki.

Kutanga Kuderedza Kukuvadzwa Kuchitsigira

Gadziriro dzokuderedza kuvadziko dzakawana kugamuchirwa kunowedzera sechikamu chinotambudza chemhinduro yeopioid. Vakuru vakuru vehurumende vakaita basa guru mukuwedzera kusvika kunaloxone, mushonga unoponesa upenyu unochinja kunyanyisa kweopioids. Vazhinji vakabudisa mirairo yakamira inobvumira masangano kuparadzira naloxone pasina mirau inotsigirwa, inotsigirwa nesangano raanoxone, uye varairi vokutanga kurovedza vatsigiri narogone uye mitezo yemhuri mukushandiswa kwayo.

Dzimwe nyika dzakawedzera nokutanga zvirongwa zvejekiseni rejekiseni (SSPS), zvinogovera mishonga inovhara utachiona, zvinoderedza HIV nehepatitis C kupfuudzwa, uye zvinopa mikana yokubatanidza vanhu nokurapwa. Nyika shomanene dzakatungamirirawo nzvimbo dzinoshandiswa, umo vanhu vanogona kushandisa mishonga vachitarisirwa nemishonga inouraya. Nepo idzi nhano dzinoramba dzichiitiranwa nharo mune zvematongerwe enyika, vakuru vakuru vehurumende munzvimbo dzakadai seRhode Island, New York, uye California dzakavasundira mberi sematanho dzoutano hwavose.

Kuchinja Kwomutemo Neruramisiro Yeutsotsi Zvinosvika

Vatungamiriri vehurumende vanopesvedzera mutemo unogona kudzokororwa kuti mhosva dzine chokuita nechinhu chimwe dzinotongwa sei uye kuti vanhu vakapindwa muropa vanobatwa sei mukati megadziriro yeruramisiro yamatsotsi. Magavhuna anoverengeka akasaina "Sanimaria" mitemo inopa kuganhurirwa kwokudzivisa kusungwa kwavanhu vanodana 911 mukati mokunwa zvinodhaka. Vamwe vakatsigira mapurogiramu anotsausa vaparidzi vemirimo vakaderera kuti vabatwe panzvimbo pokusungwa.

Mukuwedzera, vakuru vakuru vehurumende vakashanda kuvandudza kuisa mitemo, zvakadai sokuganhurira nguva nemwero wemishonga yokutanga yeopioid nokuda kwokurwadziwa kwakakomba. Nyika dzakawanda zvino dzinoda vanyorereri kuti vape dzimwe mitoo yokurapa marwadzo uye kukurukura ngozi navarwere. Panguva imwe cheteyo, magweta makuru akaronda nzvimbo dzapamutemo, kubatanidza mabhiriyoni US $6 eOpioid mugari wemo naJohnson & Johnson navanobvisa zvinodhaka, izvo zvinogovera mari nokuda kwemibato yokupindwa muropa nezvinodhaka.

Matambudziko Akasangana Navakuru Vehurumende

Pasinei zvapo nenhamburiko dzavo dzakanakisisa, vatungamiriri vehurumende vanotarisana nezvinetso zvikuru zvinoomesa kurwisana nenjodzi yeopioid.

Kuganhurirwa uye Kushandisa Mari Kusingafanotaurirwi

Mazhinji ezvipo zvemari nokuda kwedavidzo yeopioid anobva muzvipo zvehurumende, zvakadai seState Opioid Response (SOR) inopa mari inopiwa naSAMHSA. Zvisinei, iyi mipiro inowanzoganhurirwa uye inodzorwa nemisiano yezvamatongerwe enyika. Vakuru vakuru vehurumende vanofanira kukwikwidzanawo nezvimwe zvinhu zvokutanga zvemari (hprojekti), gadziriro dzoutano (hwunoita kuti kuve kwakaoma kuchengeta mari inodzivisa nguva refu nokurapa. Opioid fakin, nepo inova inorema, kazhinji kazhinji inobviswa mumakore akawanda uye ingauya neganhuriro idzo dzinogona kukurumidza sei kuiswa.

Kuoma Mupfungwa Nokushora Kwezvamatongerwe Enyika

Kupindwa muropa kunoramba kuchishatiswa zvikuru, uye vakuru vakuru vehurumende vakawanda vanotarisana nekanganisika apo vanokarakadza matanho okuderedza kuvadziko akadai seSPS kana kuti nzvimbo dzinoshandiswa dzinotarisirwa. Chishoro chinobva munzanga dzomunzvimbomo, kuchengetwa kwemitemo, uye kunonoka kwetsika. Kunyange kukura kwokurapa kunopa uchapupu kungarangarirwa se "kushandisa zvinodhaka kunoitwa nezvikamu zvehurumende, kuchigombedzera vatungamiriri vehurumende kuisa mari yakawanda munhimbe dzedzidzo dzavose.

Kudzikamisa Utano Hwevanhu Vose Nomutemo

Vatungamiriri vehurumende vanofanira kungwarira kusawirirana pakati pokubata kupindwa muropa senhau youtano uye kuderedza kugoverwa kwemirimo isiri pamutemo. Kunyanyoda kuranga kunogona kutadzisa vanhu kutsvaka betsero, nepo mitemo inoregeredza ingarangarirwa seisinetsi zvikuru mukurwisana navatengesi. Kuwana dzikamo yakarurama kwakaoma, zvikurukuru munyika dzine mari shoma uye mwero yakakwirira youtsotsi hwamasimba masimba hunobatanidzwa mumisika yemirimo.

Kugoverana Mumashoko Nokushanda Pamwe

Miitiro yeOpioid inoshanda inotsamira pamashoko akarurama, akakodzera nguva. Zvisinei, madhipatimendi ezvoutano ehurumende, masangano eMedicaid, maPDMP, uye kuchengetwa kwomutemo zvinowanzoshanda musilos namanyuko asingawirirani. Mitemo yemunhu oga yakadai seHIPAA inogonawo kudzivisa kugoverana mashoko. Vakuru vakuru vehurumende vanofanira kuisa mari mutsinhano dzamashoko dzoutano uye kubatanidzwa kwemashoko ezvokufamba-famba kuti vazive njodzi dzinomuka (g., mitaro, murufu rwefentanyl).

Maruwa Nemisiano Yamataundi

Njodzi yeopioid inotapura nzanga dzose dziri mbiri dzomumaguta namaruwa, asi denho dzinosiana. Nharaunda dzomumaruwa dzinowanzoshaiwa varapi vanopindwa muropa, mabasa anokuvadza, uye zvokufambisa zvavose kundosonga. Nharaunda dzemataundi dzinotarisana nemhesano huru yefentanyl nezvinodhaka zvokugadzira, uyewo kusava nedzimba huru zvikuru uye chirwere chendangariro chinovapo. Vakuru vakuru vehurumende vanofanira kuronga mitemo inowirirana neiyi migariro yakajeka-jeka yakadai sea yemipimo yemari inovakwanisira zvinhu zvisingawanzoshandiki.

Kukurira Matambudziko Kupfurikidza Nokuvandudza Nokushanda Pamwe Chete

Pasinei zvapo nemhinganidzo idzi, vakuru vakuru vehurumende vakawanda vakaratidza mano okufunga anoshamisa uye kutsunga. Vakagadzira mapepa ezvikamu zvenyika yepamusoro kuti vagoverane miitiro yakanakisisa, vakabatana nezvisingabetseri sezvirongwa zveNational Gavanal Association, uye vakabatana zvakananga nenzanga dzinotapurwa nokupindwa muropa. Vamwe vakagadza "vatongi vehurumende" kuti vatsinhiranise mhinduro yacho mumasangano uye kuva nechokwadi chokuti mari inopedzwa zvinobudirira.

Ruzivo rwemakombiyuta runewo mikana mitsva. Zvikamu zvakawanda zviri kushandisa michina kudzidza kufanoziva kuti kana munhu akanyanya kuwanda, angashandisa mahomoni anenge achinyanya kupisa kana kuti kuparadzira maapurobhuroko. Zvimwe zvakashandisa maapps anobatanidza vanhu nemadhiragi okurapa panguva chaiyo. Vakuru vakuru vehurumende vanobvuma zvinhu zvitsva zvakadaro vanogona kuita kuti zvinhu zvive nani kana vaine zvinhu zvishoma.

Fundo Dzenhau: Kutanga Kubudirira Kwehurumende

Kunzvera masangano chaiwo kunogovera zvidzidzo zvinokosha nokuda kwezvinoshanda — uye chisati chiri chisati chiri — muitiro weopioid.

Ohio: Mhinduro Yechikamu, yeDrime - Drivery

Ohio yave iri pamavambo enjodzi yeopioid, nemwero yenzuru yerufu yakanyanyisa pakati pedzinopfuura dzose munyika. Mumhinduro, Gavhuna Mike DeWine akatanga "Ohio Opioid Response" muna 2019, achibatanidza mamirioni anopfuura $200 kubva kumari yehurumende uye mari inogoverwa. Nhanho dzinobatanidza kukura kusvika kuruvara rwebitfemu yekurumidziro, mari yezvikamu zveutano zvinofambikanwa zvinosvika kumaruwa Appalcapea, uye kuumba Hurumende ye "Opioid Flackboard" kuti ipfuure, mabhii, uye basa rokurapa. Nyika yakatengwa zvikuru munasogone uye mubato womutezo womutemo kunongedzera kuvanhu kunzvimbo yejeri. Semuuyo wekurovanya, rufu muOhine inoderera ne4% 2% mu201 muinotangira kumimwe mitengo 202, uye kupfurikidza neimwe miraudzo.

Rhode Island: Kutama - tama Kunokuvadza Nokurapa

Rhode Island yakaita kusvika kwoushingi kupfurikidza nokubatanidza kuderera kwekuvadziko mugadziriro yayo huru youtano. Munsi maGavhuna Gina Rainondo uye gare gare Gavhuna Dan McKee, hurumende yakawanira mari mutyairi wenzvimbo anotarisirwa wokufambisa ndege .www. uye Hurumende yakakudza gadziriro dzayo dzebasa rejekisensi kubatanidza zvikamu zvetsono nerokutarisira maronda. Rhode Island yakabatanidzawo mufananidzo wokurapa wakawedzera zvikuru nhamba yavanhu vanogamuchira MATE. Pakasvika 2023, nyika yakashuma kuderera kwe12% yemichina yejekiseni mukupfuudza nokupfuudza nokupfumba kwemaririra.

West Virginia: Kupedza Mipikidzano Yomumaruwa

West Virginia ine mwero wenzufu dzinopfuudza zvikurusa munyika ino, asi vakuru vakuru vehurumende vakatora matanho okudenha kukurukura nzvimbo dzokupinda mumaruwa. Gavhuna Jim Justice akakudza purogiramu yeMedicaid kuti ifukidze MEDID ndokushandisa hurumende kupa mari kuumba "matutu emhinduro dzechipameso" anoshanyira vapukunyuki vanonyanyisa mumisha yavo. Hurumende yakatangawo nzvimbo yezvikuva yemaruwa inobatanidza vagari vomumaruwa nenyanzvi dzokupindwa muropa paWest Virginia University. Nepo denho dzacho dzakabetsera kuderedza nhamba dzorufu dzinopfurwa nedzinowedzera kubhadhakisa nokuwedzera kuwanda kwamakore 15% mukuvara.

Nhungamiro Dzomunguva Yemberi Nokuda Kwechiito Chehurumende

Njodzi yeopioid inopfuurira kushanduka, nokukwira kwemapiritsi okunyepedzera ane vhaisi, xylazine (mushonga wemhuka), uye kushandiswa kwepolyncstance. Vakuru vakuru vehurumende vanofanira kutangira izvi. Nguva yemberi inofanira kubatanidza:

  • [ Kupinza mumiitiro chaiyo yokunzvera [ inogona kuona zvinobuda ndokunyandura mhevedzo dzoutano.
  • Kutsvaka nzira dzokurapa (kurapa kunopa simba) nokuda kwokukurudzira uye kurapa nokushandisa polysubstries vhiringidziko, dzinotsigirwa nokunzvera kunoratidza kushanda kwadzo.
  • Kuparadzira mabasa okupindwa muropa kupfurikidza nokushandisa mari kurovedza nyanzvi dzokunaya kwezera ravo, vanachiremba, uye vabetseri vachiremba kugovera MPU.
  • Kunzvera kwepasi pose nokuda kwokushandisa vhiringidziko yezvinhu mutarisiro huru, madhipatimendi ekurumidziro, uye kiriniki dzapamberi pokusununguka.
  • Tsinhirano inosimbisa mativi echikamu chenyika pakunzvera pamutemo namashoko okusimbisa anogoverana kudzongonyedza gadziriro dzokutengesa mirimo.

Gavhuna nezvikwata zvavo vanofanirawo kupfuurira kuronga misha yapamutemo yakatsaurirwa, yenguva refu kugadzira hova dzemari nokuda kwamabasa akapindwa muropa nechakaipa — vachidzivisa mari yacho kutsaurirwa kumari dzinoshandiswa. Nhimbe dzedzidzo dzavose idzo dzinoita kuti vanhu vapindwe muropa ndokuderedza ruzvidzo dzinoramba dziri madikanwa kuvaka tsigiro yavose yakafara.

mhedziso

Vakuru vakuru vehurumende imhinduro yeminchpins yeAmerica njodzi. Chiremera chavo pagadziriro dzoutano, mabhajeti, uye mutemo zvinovapa mano akasiana okushandura ufakazi muchiito, kuponesa upenyu, uye kuderedza kuparadza kwenzanga nedzemari kunoparirwa nokupindwa muropa. Nepo zvinetso zvakadai semitengo yemari, ruzvidzo, uye chishoro chezvamatongerwe enyika zvichipfuurira, utungamiriri hwechitsva nehwakaro hunoratidzwa munyika dzakadai seOhio, Rhode Island, uye West Virginia zvinoratidza kuti fambiro mberi inobvira.

Sezvo denda racho rinopfuurira kushanduka - shanduka, kuzvipira kunopfuurira kunobva kuvakuru vakuru vehurumende − pamwe chete nokubatira pamwe namasangano ehurumende, nzanga dzomunzvimbomo, uye vatarisiri vezvoutano — kuchave kunokosha. vavariro haisati iri yokungoderedza bedzi nzufu dzinonyanyisa, asi kuvaka gadziriro ine udzame, yetsitsi, uye inosimba iyo inodzivisa kupindwa muropa nokutsigira kunaya nokuda kweAmerica vose.

Nokuda kwamashoko akawanda, ona CD'S Drug National Overdose Surveillance, Gavhuna vorudzi Association Opioid Initive, uye [[FLT:]] NPR kutevera kwemari yemari yemari yehurumende yemari yehurumende [.