Table of Contents

Indima Yetyala Leendlebe Zengqungquthela Ekuthetheni Nengxaki Yesifo See-Opioid Nempilo Yoluntu

Isibhak-bhaka esingubhubhani sivele njengenye yezimo zongxamiseko zempilo kawonke-wonke ezitshabalalisayo kwimbali yanamhlanje yaseMerika. Ukususela ekupheleni koo1990, ukusetyenziswa kweopioids ezidambisa iintlungu ezigqithisileyo, kulandelwa kukunyuka kwe-heroin kunye nokusetyenziswa kwe-opioid, kuye kwakhokelela kumakhulu amawaka abantu ababulawa yile ngxaki yokusetyenziswa kakhulu. Ngokwe-U.S. iziko lolawulo lwezifo kunye nothintelo lweziyobisi (CDC), phantse abantu abali-108, 000 000 000 bafa ngenxa yokusetyenziswa kwamayeza agqithe kakhulu ngama-ankiyo ngo-20222, kunye nokusetyenziswa kwe-fantiyo esetyenziswayo efana ne-fentyyl, i-fylyn ebandalgracrive ([[FLT] CD-OverOverDricitectic syst [FFoses:1]). Kwintskoqo lwezibonelelo lobugciso-omatili yezo-ographic, i-ogcustom,

Injongo Nesiseko Seengxubakaxaka Zokuchotshelwa Kweendlebe

Iintlanganiso ezisemthethweni zeBhunga ziqhutywa ziikomiti okanye amaqumrhu angaphantsi eBhunga okanye iNdlu yeeNdlu yeeNdlu yeeNdlu. Imisebenzi yabo ephambili iquka ukuqokelela inkcazelo, ukuvavanya ukuphunyezwa kwemithetho, ukuvelela amasebe aphetheyo, kunye nokuphuhliswa kwezicelo zomthetho-mthetho. Kumongo wobunzima beOpioid, iindlebe ziye zasetyenziswa ekumanyaniseni abasebenzi bemiqathango, ukunyanzelisa uluntu, ukuqinisekisa ukuba amayeza, kunye nenkcubeko echaphazelekayo.

Ukuqokelelwa kolwazi kunye nokuFunyelelwa kweNkcukacha

Ukuva kuvumela abenzi bomthetho ukuba beve ngqo kwiingcaphephe, kumagosa karhulumente, kunye nabantu abaphilayo. Obu bungqina bunceda iNgqungquthela iqonde ukuntsonkotha kobhubhani we-opioid, ukusuka kwimiqathango ebhaliweyo kunye nenzululwazi yokukhotyokiswa ukuya kumatyathanga angekho mthethweni kunye nezithuba zonyango. Umzekelo, ubungqina obuvela kwiDrug Enforcement Administration (DEA) buye batyhila indlela izigalelo ze-pilisi kunye noncedo lwe-oglogisi eziphakathi kwezizwe ngezizwe ezixhobisa ngayo ingxaki ( DA DIA Inye Pill Eging Capug Campties[FLD [FLT]]]). Ngokufanayo, abaphandi bezempilo basekuhlaleni ngoncedo lonyango olusebenzayo, njengonyango oluneyo lwe-ARPT) kunye nohliyo lwengozi.

Ukuphendula nokulawula

Ulawulo lweziko lombuso lusoloko lungqina imigudu yabo yokulwa neengxaki. Kwiziko eliphezulu, amasebe eendlebe zempilo neeNkonzo zoluntu (HS), iDEA, i-Food and Drug Administration (FDA), kunye neNational Institutes of Health (NIH) anikela ubungqina ngemigudu yabo yokulwa neengxaki. Kwiziko eliphakamileyo, amagosa aye acetyiswa ngokucotha kokuvelisa i-fentanyl, ukungenelanga komgaqo we-opioidod qum, nokungaqiniseki konyango lokuvuma. Oku kumelelwa kunokukhokelela ekulahleni, ekutshintsheni kwemiqathango, ekufumaneni intlawulo, kunye nokuxhaswa kwemali eyandayo.

ISibonelelo soMgaqo-nkqubo

Hearings often serve as the starting point for new laws. The testimony, expert recommendations, and public pressure generated during a hearing can shape the text of bills. For instance, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018 — a landmark piece of legislation — drew heavily from findings presented in multiple hearings across several committees. Bipartisan coalitions formed around shared concerns about the crisis, leading to measures that expanded access to MAT, improved prescription drug monitoring programs, and increased penalties for fentanyl trafficking.

Izihloko ezingundoqo ezihlolisiswe kwi-Opioid-Rebled Phose

Kwiminyaka elishumi edluleyo, ukuchotshelwa kweendlebe kwequmrhu kuye kwahlola imibandela emininzi enxulumene nokusetyenziswa kakubi kweopioid nokukhotyokiswa.

Ingxelo yokwandiswa kwezakhono neMichiza

Enye yeenkcazo zokuqala yayiyindima yabaxhasi bezonyango kunye neenkampani zeziyobisi ekupheliseni lo mlingo. Iindlebe zachaza indlela urhwebo olunobundlobongela lweenkampani ezinjenge Purdue Pharma oluzichaphazele ngayo iingozi zokukhotyokiswa yiprojekthi ze-opioids ezizii-opioids ezininzi. Abenzi bomthetho babuza abalawuli abalahlekisayo ngezinto zokunyusa ingeniso, ukusetyenziswa kwe-opioid ngokufaka izikhuthazo, kwaye ukungakwazi ukunikela ingxelo erhalalisayo. Ezi zimvo zanceda ekubhexeleni iziphumo zeshishini lamayeza kwimichiza eenjilitha engqungquthelayo kwaye zakhokelela ekungeneni kwemigqele yemibalwano yezo zincwadi zomthetho. Ubungqina bukawonke-omatila angaphambili nabameli be-pipipetrover banika ubungqina obunamandla obuthiweyo obuphembele imbono kawonke wonke kunye neyo.

Ukufumana unyango lobukhoboka kunye neenkonzo zokuchacha

Omnye umxholo ophindaphindwayo ngumahluko phakathi kwenani labantu abanesifo sokusebenzisa i-opioid (OUD) kunye nokufumaneka konyango olusekelwe kubungqina. Ukuva kuye kwabalaselisa ukunqongophala kwabanikezeli abanokuthi bagunyazise i-buprenorphine kunye ne-metahadoni, ixabiso eliphezulu lonyango, kunye nemiqobo ye-inshorensi. AmaNgqina asuka emaphandleni achaza uludwe lokulinda iinkqubo zedetox kunye nokungabikho kweenkonzo zempilo zengqondo. Ekuphenduleni, iBhunga lokuphulaphula liye labamba iindlebe ukuze lichaze imfuneko efana nokuphelisa i-X-waeveternorenomine (ekube kususiwe ekugqibeleni ngo-2023), ukwanda kwe-temperal yezonyango zobugracrali, kunye nokuxhaswa kwemali ekhulayokusetyenziswa kwii-Substance Abust Abust syst sy Services (SA).

Ukuvela KweeOpioids Ezibangelwa Zii - Synthetic Nefentanyl

Ukusuka kumyalelo opioids kusuka kumyalelo wefentany engekho mthethweni kunye ne-nalog yakhe kuye kwaba ngumxholo omkhulu ukususela 2016. Ukuva kuye kwahlola indima yabalungiseleli bemichiza baseChina naseMexico, iingxaki zokufumana nokuvala intwana encinane yefentanyl, nobunzima bokuzitshintsha ngokugqithisileyo kwimichiza egqithisileyo. Amagosa omthetho aye anika ubungqina beendlela zokungenisa iindlela zokungenisa, ngelixa iingcali zempilo kawonke-wonke zixubusha ngemfuneko yokusasaza okusasaza okusasazekileyo kunye nokuvavanya imibala encinane. Enye i-2023 ephawulekayo yokuva phambi kwe-State Homeland Socialland nePunications ijolise ekuqiniseni ikhuni elinamandla kakhulu kunye nokuchana kwemichiza ([FLD [F]]

Ubuchule bokukhusela abantu abakwi-Atkiski

Kwakhona iindlebe ziye zahlola indlela yokuthintela ukusetyenziswa kakubi kwe-opioid ngaphambi kokuba iqale. Oku kuquka iingxubusho kumaphulo emfundo, iinkqubo zokuhlola amayeza kagqirha (PDMP), ukunika imigaqo, nokulahlwa koncedo olunzulu lwamayeza angasetyenziswayo. Ulwazelelelo olukhethekileyo lunikwa abaselula, amagqala, nabantu abaneentlungu ezingapheliyo. Ingxelo evela kwisikolo, amagosa empilo kawonke-wonke, kunye neenkokeli zezonyango zezonyango ziye zazisa amanyathelo afana “Ukuyeka Ukusetyenziswa kweTshayina kweziyobisi” kunye“ neenkqubo zokulawula iPropicrain . Iimfuno zamaqela angaqhelekanga akwimibutho eyahlukeneyo — njengemibalwaneempumaMerika namaIndiyake nama - Alas — ziye zabalazwe kwizakhono ezinikezelwayo.

Uphando, ugcino-lwazi, nokubuyiselwa

Kugxininiswa kakhulu ekufuneni uqokelelo olungcono logcino-lwazi kunye nophando lwenzululwazi. Iindlebe zihlolisise iinkqubo zokuhlola iCDC, i-NIH’S HEAL Initativery, kunye nokuphuhliswa konyango lweentlungu olungelulo umgangatho. Abenzi bomthetho babuza ngokuphindaphindiweyo malunga nezithuba ekudibaneni ngogcino-lwazi phakathi kwamazwe, ukulingeneka kwexesha lokwenene lokusetyenziswa kwemali ngokugqithisileyo kokuxela ukululama kwexesha elide.

Impembelelo yeeNkcukacha eziBalulekileyo kwiMigaqo-nkqubo naseMnyangweni

Ngoxa iindlebe zizezodwa zingacombululeli ngxaki, iziphumo zazo zokubetha zinokuba zinzulu. Zibumba umthetho, ziguqula ingxelo kawonke-wonke, ziphembelela izenzo zamaqumrhu azimeleyo nawoluntu.

Iziphumo zoMgaqo-siseko

Inkqubo engqalileyo iquka ukudlula koMthetho weSiphatho soMsebenzi weCandelo, uMthetho we-Opioid Response, kunye neendleko ezininzi zoluvo-luvo zonyaka kunye neemali ezithe zanda ngenxa yemali edityanisiweyo yonyango kunye nokuthintelwa. Umzekelo, uMxhasi woMthetho wanikela ii-irandi ezingamawaka asibhozo,4 ezigidi zeminyaka emihlanu kwiinkqubo ukunqumla i-HHS, kuquka iimpendulo ze-opiojoids ezinika inkxaso-telehealth ukufikelela, kunye nokufumaneka kakhulu kwe-buplenorphine. Ngokutsha, i-2023 Contived Appriations Appropect yaquka amalungiselelo okuva kwi-metham-fine, ukuthumela izinto ezintsha zokuthintela. — njengoko kufunwa kokulawula izinto ezilawulwayo.

Izenzo zolawulo ne-arhente

Iintloko ze-arhente zisoloko zichaza imithetho emitsha okanye ukugcinwa komthetho okuphambili ekuphenduleni imibuzo yokuva. I-DEA ilungise imveliso ye-opioid efakwa ngonyaka emazantsi emva kokuva okuqatshelwe ngaphezulu. IFDA ikhawulezisa uhlolo olungaphezulu kwe-naloxone kunye nonyango olutsha lweentlungu. ICDC ihlazisile izikhokelo zayo ezimiselwe kusengaphambili ngemida eqinileyo esekelwe kubungqina obunikelweyo. Olu tshintsho, ngexa ulwandiso, lunokuba neziphumo ezikhawulezileyo kwisimilo kunye nokhuseleko lomguli.

Ubungqina boluntu notshintsho

Ukuva okunesandi kuzisa ingxaki yamagumbi okuhlala aseMerika, kubangela ukuba abantu babe ngamakhoboka obuntu, kunciphisa ihlazo. Xa amalungu entsapho amaxhoba okusetyenziswa ngokweqile engqina, amabali awo anokuvakala kwizigidi zabantu. Ukubonakala kweendlebe kukwabangela ukuba iinkampani zamayeza, ii-pharmacy, kunye neengxolo zokuthelekisa iingxolo ezingqongqo kunye norhwebo. Ukuphandle kwabantu ngenxa yokuva kuye kwanegalelo ekusetyenzisweni kwemithetho elungileyo yamaSamariya, ukwanda kolwamkelo lomonakalo, nokuncitshiswa kolwimi olunemfesane kumajelo eendaba.

Imizekelo Yezindlebe Zakutshanje Nezinempembelelo

Ukuze ubone indlela ezi ndlebe ezisebenza ngayo ngexesha lokwenene, khawuqwalasele imizekelo emininzi ebalulekileyo yeminyaka emine edluleyo.

2021 IKomiti yeNdlu yeeLwimi Ukuphulaphula iOpioid Ukuqhatha nokuxhatshazwa kweeNkqubo ze-Efreed Health

Oku kuthethwa kwahlola indlela intlekele ye-opioid edityaniswe ngayo neMedicaid, ijolise ekunikeni imiyalelo yokukhohlisa, amatyathanga agcina iipateni zonyango olukrokrelayo, kunye nendima yekhemikhali eluncedo kubaphathi be-ekhemisi. Ubungqina obuvela kwi-HHS yeNqanawa ye-Inspector jikelele butyhile ukuba izigidi zeerandi zichithe imiyalelo engeyomfuneko ye-opioids ukuze zifumane uncedo. Ukuva kwakhokelela ekuphuculeni uphando lwezixhobo zohlalutyo kunye nezigwebo eziqinileyo zabaxhasi abasebenzisa izinto ezingalawulwangasetyenziswanga nyango.

2022 Amandla endlu kunye nokulawula ikomiti engaphantsi kwenqanawa ephulaphula ii-opioids ezingqubanayo

Ngokunyuka kwefentanyl kufa, le migudu yokuphulaphula ibekwe kwimichiza edityanisiweyo. Abenzi bomthetho beva kwiDEA, kwiSebe Lokhuseleko Lomhlaba, kunye neengcali zempilo zikawonke-wonke malunga nokunyuka kwe-fentanyl engaphambili eTshayina kunye nobunzima bokuyilawula. Imigudu ekhawulezileyo yokudwelisa imichiza njengezinto ezilawulwayo kunye nenkxaso yemali yezixhobo zokuhlaziya ifentanyl-dete ex amacala okungena kuwo. Ikwabalase imfuneko yokuba kubekho intsebenziswano yezizwe namazwe apho le michiza iveliswa khona.

2023 IKomiti yeNtlanganiso yezeMpilo, Imfundo, Imisebenzi, neNkcubeko (HELP) Ethetha ngeTelehealth nonyango lobukhoboka

Ngexesha lesifo esingubhubhani, i-telehealth proponetilials zandiswa ukuvumela i-bouplenorphine ibhalwe ngokufowunelwa ngesandi kuphela. Olu ndlebe lwavavanya ukusebenza nokulingana kwezo nguqu. Iingcali zanikela ugcino-lwazi olubonisa ukuba unyango olukude olunyusiweyo kwiindawo zasemaphandleni ngaphandle kokuzilibazisa okukhulayo. Ukuva kwakhiwe kwesivumelwano sokwenza ezi ngxaki zibekho ngokusisigxina, eziboniswe kumthetho wama-2023 Telehealth Modertization Act kunye notshintsho olulandelayo lwemithetho yeMedicare.

2024 Ikomiti ePhantsi yeNdlu yeNdlu eTshayina Ukuphulaphula IiParmacy Chains noMqedazwe weOpioid

Ukuqhubeka nokugxininisa kwimbopheleleko yenkampani, oku kuva kwahlola indima yemixokelelwano emikhulu yekhemikhali (umz. CVS, Wal Greenpees, Walmart) kwimimandla engaphezulu ehlala abantu ngeopioids. Ubungqina obuvela kubathengisi bangaphambili nakumaxwebhu angaphakathi bubonise indlela uxinzelelo lwenkampani lokuhlangabezana nomlinganiselo worhwebo olukhokelela ngayo ekuzaliseni imiqulu emikhulu yomthetho womthetho wokubhaliweyo ngaphandle kokukhuthala. Ukuva kwafak ’ isandla ekuqhubekeni kokumangalelwa nokuhlala, kwaye kwakhuthaza umthetho owe-morenti yomgangatho karhulumente ofuna ii-pharomackethi ezifuna ukuqinisekisa ukufaneleka koopioothematikethi.

Iingxaki Nokugxekwa KweeNkundla Zokuchotshelwa Kwetyala

Nangona ukuva kuxabisekile, kodwa kukho imiqathango.

Ukwahlula-hlula kunye nokuma

Ezinye iindlebe zisuka zingene kwiholo yezopolitiko, abalawuli bezomthetho besebenzisa ixesha labo ukufumana iingongoma ezichaphazelekayo kunokuba babuze imibuzo encinci. Oku kunokuyinciphisa injongo yokuqokelela ulwazi kuze kunciphise ukuthemba uluntu. Umzekelo, ngexesha lokuva kwe-profile ephezulu, amanye amalungu asebenzisa ithuba lokuhlasela izikhundla zeqela elichasanayo ekuphuculeni impilo, ukuncitshiswa kohlolo lwe-opioid.

Ukungabikho kokulandelela

Iindlebe ezininzi zivelisa ubungqina obunyanzelisayo kodwa aziphumeleli kwizenzo zomthetho okanye zomthetho. Inkqubo yoorhulumente iyakwazi ukuvala iingcebiso kangangeminyaka. Ngaphandle kokungakhathalelwa, izithembiso eziye zanikelwa ngexesha lokuchotshelwa kwetyala zingalityalwa. Ukusilela ukulandela iingcebiso zangaphambili eziphathelele inkqubo ka-DEA yaba ngumsantsa ophawulekayo owabangela ukuba le ngxaki ibe mbi ngakumbi.

AmaNgqina Ahlukahlukeneyo

Maxa wambi amatyala asoloko esetyenziswa ziingcali ezifanayo, ngaphandle kwamazwi kwimibutho ekwakheni iingca, abantu abakhotyokiswe ngokutsha, okanye abasebenzi abanyangayo abakwimida yemfazwe. Oku kusenokuphazamisa ukuqonda oko kusebenzayo kwingingqi yoluntu. Ezinye iikomiti ziye zenza imigudu yokuquka amazwi ahlukeneyo, afana nezigulana ezichachachayo, kodwa asele ekho.

Umda Ongaphelelanga

Ezinye iinkalo ezibukhali zengxaki zifumana ingqalelo encinci, njengoqhagamshelwano phakathi kokunikwa i-opioid inikwe i-opioid kunye nokusetyenziswa kamva kwe-heroin, iimfuno zokulawula iintlungu ezikhethekileyo zamaqela aphantsi, okanye indima yezoshishino ezingokwasemthethweni nezingekho mthethweni nezinye izinto ezidibanisa lo mxube. Ukujolisa kwifentanyl maxa wambi kuye kwafihla inani eliqhubekayo lamayeza agunyaziswayo kunye neziyobisi ezingezobugcisa.

Ulwalathiso Lwexesha Elizayo: Ukomeleza Indima Yokuva

Ukunyusa ukusebenza kwetyala lokuchongwa kwentlanganiso ekuthetheni nengxaki ye-opioid, kufuneka uphuculo oluninzi.

Ukwanda Okungcono Kogcino - lwazi Nobungqina Obuyingcaphephe

IiKomiti kufuneka zifake ingeniso kuphando oluzimeleyo nobuchule bobungcali bokujonga ubungqina obunikiweyo. Umzekelo, i-ofisi kaRhulumente (GAO) ingasebenza ngokuvelisa uhlolo olukhawulezileyo lwendlebe nganye. Oku kuya kunceda abenzi bemithetho bahlule ugcino-lwazi oluqinileyo kulwazi olusemngciphekweni okanye olunekhethe.

Ukwanda kokubonisa ngaphaya kunye nomatshini olandelwayo

Ukucela amaziko ukuba aphendule ekuhleni ebhalela icebiso ngalinye elikwisakhelo esimiselwe ixesha elifanelekileyo kuya kuphucula ukuphendula.

Amaqela AmaNgqina Ahlula Ucalulo

IiKomiti kufuneka ziphuhlise iindlela zokuqinisekisa ukuba abantu basemaphandleni nabahlala ezidolophini, abantu abavela kwiintlanga ezincinane, ubudala, namaqela ahlukeneyo eembono zeminyaka, kunye needolophu kunye namaphandle. Ukuquka abantu abaninzi abasebenzisa iziyobisi okanye ezisetyenziswa ngaphambili besebenzisa iziyobisi kungenza amanqam kunye nenkqubo yomhlaba ekuboneni ukuba linjani na ihlabathi.

Imikhosi yomsebenzi enqamlezayo neBpartisan

Ngenxa yokuba iOpioid eyingozi ilinganisa impilo, ukunyanzeliswa komthetho, urhwebo, kunye norhwebo, ukuchotshelwa kweendlebe phakathi kweekomiti kunganikela imbono ebanzi. Ukuseka umsebenzi osisigxina we-bipartis othetha ngokukhotyokiswa nokuthintelwa kokusetyenziswa kakhulu kweziyobisi kunokuzigcina zisemgangathweni phakathi kweentlanganiso kunye noncedo olulungelelaniswe kwiiKhonklathi nakwisebe eliphetheyo.

Isiphelo

Ukuva okuququzelelwayo akuyonkqubo nje yokomfuziselo. Kusebenza njengendlela ebalulekileyo yokubhenca imvelaphi yengxaki ye-opioid, ibeka ityala kubadlali abanamandla, nokuguqulela ubungqina kwisenzo. Ngoxa kungezona zonke iindlebe zinika umthetho omtsha okanye utshintsho olulawulayo, iziphumo ezingapheliyo zobuveleli obuqhubekayo kunye nengxoxo kawonke-wonke zibuchaphazeli zibulolo oluye intsabelo yesizwe. Uphando lwangaphambili luye lwaguqula ukusetyenziswa kwenkcazelo ye-oplyn ephambili kunye nokuthengiselwa kweziyobisi kugxininiso oluphambili kwinkqubo yakutshanje yokurhwebelana ngefantilyn kunye nonyango lwe-telhealthring, ezi zikhala zinyanze iingxube iingxoxo ezinzima kwaye zixhokonxane zezizathu ezinzulu, ii-bissss, ukunyanzela intswook-od syn elungele ukuvalka, ukuva, ukunyaniswa kwethemba kunye nokusetyenziswa kwemithetho engongongongongongongongongongongongongongongongongongongongongongongongo