Ingxaki Yeoli Nendima Ephakamileyo Yabalawuli Belizwe

Ubhubhani wesibhaka-bhaka uhlala ungomnye wezona zinto ziyingozi zempilo kawonke-wonke kwimbali yanamhlanje yaseMerika, ubiza amashumi amawaka obomi kunye noxinzelelo lweenkqubo zonyango, ukunyanzelisa umthetho, kunye noluntu. Ngoxa amasebe karhulumente enikela inkxaso-mali kunye nemigaqo ebanzi, iintambo eziphambili zokuphendula zilawulwa ngurhulumente. /iisebe lezolawulo-Rhulumente ``iigovernor, ijajijaji, ingingingi yoogqesi-mthetho, kunye negunya elibalulekileyo lokubumba imigaqo echaphazela ngokuthe ngqo ukusetyenziswa, ukukhotyo, ukukhutshwa, ukukhutshwa kwengozi, kunye nokugcinwa komthetho. Izigqibo zazo zigqiba indlela ezikhutshelwa ngayo, nendlela ezinyanzelelwa ngayo, nendlela ezinyanzelelwa ngayo, nendlela abasebenzi bobungqina obukhawulezayo bokungenelela kwabo abo basweleyo.

Eli nqaku lihlolisisa indima ebalulekileyo yabalawuli bakarhulumente edlalwayo ukuhlangabezana neengxaki ze-opioid, iindlela ezingundoqo zomgaqo-nkqubo abawusebenzisayo, imiqobo abajamelana nayo, kunye nemizekelo yehlabathi yezenzo zempumelelo zemeko. Ngokuqonda ezi ntshukumo zinamandla, abaxhasi betyala bangaxhasa ngokungcono kwaye basebenzise imigaqo esindisa ubomi kwaye banciphise iziphumo zexesha elide zobhubhani.

Indima Yabalawuli Belizwe Ekulweni Nobhubhani WeOpioid

Abalawuli bephondo banikwe isikhundla esikhethekileyo sokulungelelanisa iimpendulo ezilungelelanisa amasebe ezempilo, iiofisi ze-Medicaid, iziyobisi, iinkqubo zonyango lwengxaki, iinkqubo zomthetho, kunye neenkqubo zemfundo. Bamisela indlela yokufikelela ekukhotyokisweni yi-(ukukhotyokiswe) nanjengomcimbi wezobulungisa, ucelomngeni lwempilo kawonke-wonke, okanye ukudityaniswa kwazo zombini. Imiyalelo yabo yabalawuli, izicelo zoqingqo-mali, kunye nemigaqo yemithetho yomthetho ingenza okanye ithintele ukusetyenziswa kwemiqathango eqinisekisiweyo.

Ngokomzekelo, abalawuli banamandla okuvakalisa ungxamiseko lwempilo kawonke-wonke, olunokuvula inkxaso-mali ebhetyebhetye kunye nezikhuphi-mthetho ezilawulayo. Bangamisela kwakhona amajoni omsebenzi, abalathisi besizwe ukumisela unikezelo lwe-anoxene, kwaye banxibelelane nabaxhasi bempilo ukususa imiqobo yonyango lwamayeza (i-AMT). Auttorney jikelele, ngelinye ixesha, bakhokela i-litimeta yamazwe amaninzi ngokuchasene nabenzi bomchazi-mayeza kunye nabarhwebi, ukukhupha amawaka ezigidi zeedola zemali ezinokuxhasa iinkqubo zokuhlola ukukhotyoliswa. Abameli bezonyango borhulumente bongamela iinkqubo zokuhlola amayeza (PDMPS) kunye nogcino-lwazi-lwazi oluqhelekileyo olunolwazi olukhombayo olunolwayo olusetyenziswa ngaphambi kokuba i-accolicre.

Kuba ingxaki ye-opioid iguquka ngokukhawuleza-susela kwii-opioids zomyalelo ukuya kwi-heroin ukuya kwi-fentanyl kwaye ngoku kwi-xylazine agelators", abalawuli bamazwe kufuneka basoloko bezitshintsha iindlela zabo zokuqhuba. Ukhokelo lwabo lubalulekile ukuze bagcine inkqubela kwaye baqinisekise ukuba imigaqo isoloko ihambisana nobungqina bakutshanje nezisongelo ezivelayo.

Iinkqubo ezingundoqo ezisetyenziswa ziinkokeli zikaRhulumente

Abalawuli belizwe baye basebenzisa iindlela ezininzi zokunciphisa ukusetyenziswa kakubi kwe-opioid, ukuthintela ukusetyenziswa kweziyobisi ngokugqithiseleyo, nokunyusa ukufikelela kwinkathalo. Ngelixesha kungekho ndlela inye esebenzayo ngokuzikhetha, ezi ndawo zilandelayo zingqine zinegalelo elikhulu.

Ukufumana unyango nonyango olufuna amayeza

Esinye sezixhobo ezisebenzayo ezichasene ne-opioid yokusebenzisa ukuphazamiseka (OUD) lunyango oluncediswa ngamayeza (IMPA) oluquka i-metharone, i- buplenorphine, kunye ne-naltrexene. Iirhuluneli ezininzi ziye zamisela ukwandisa umthamo we-MTHETS ngokunyusa inkxaso-mali yeekliniki, ukunciphisa iimfuno zogunyaziso, kunye nokuxhasa iiyunithi zonyango lweselula. Amazwe amaninzi akwandisa uMdicaid ngaphantsi koMthetho we-Affordable Carence, enika intethelekiso yonyango olukhobongela abantu abadala abafumana imali ephantsi. Uphandolo lubonisa ukuba iMedid yandisa ulwando olubalulekileyo ekusetyenzisweni kwe-MTY kunye nokunciphisa ukufa kwabantu.

Abalawuli besizwe bakwasebenza ukususa imiqobo yemithetho. Umzekelo, abanye baye bavala imfuneko ye-raveter eyahlukeneyo yokugunyazisa i-budrenorphine (imodeli ebizwa ngokuba yi "X-waiser"), inyathelo kamva eliboniswa yinkqubo karhulumente. Abanye baye bafaka imali kwiinkonzo zetelehealth, ukuvumela izigulana ezisemaphandleni ukuba zifumane iingcali zokukhotyokiswa. Ngaphezu koko, iinkokeli ziye zaxhasa "hub-app no-pilot" imizekelo, apho amaziko okuzimodelisholo olukhethekileyo (iiib) alungelelanisa abanikezeli abaphambili (izibonelelo) abaphambili zokuzinyamekela abahlala besenza unyango.

IiNkqubo zokuHlola iMichiza eHlabathi (PDMP)

Ii-PDMP ziziseko zogcino-lwazi zezixhobo ze-elektroniki ezinomgangatho wemeko elawulwayo. Xa zisetyenziswa kakuhle, zinceda oogqirha bamaziko okuchonga izigulana ezisenokuba zisebenza ngoomatshini okanye ukufumana ii-apwoids eziyingozi ze-opioids kunye ne-benzodiazepines. Abaphathi-magunya belizwe baqinise ii-PDMP ngemiba egunyazisayo, ukudibanisa ugcino-lwazi neengxelo zempilo ze-elektroniki, kunye nokwenza iinkqubo ezidityani ezidityaniweyo ezidityaniswe kwii-oids ze-opieps ngaphambi kokuba zihlolwe iintlungu ezibukhali (umz., emva kwenkqubo zamazinyo) ukunciphisa umngcipheko wokusetyenziswa kakubi kwempilo.

Abalawuli belizwe abatsha baye basebenzisa ugcino-lwazi lwe-PDMP ukujolisa izindululi eziphezulu, ukuthumela iingxelo zomcebisi wengxelo, kunye nolwahlulelo lwabantu abafumana amaqondo angaphezulu aphezulu aphezulu aphezulu aphezulu asetyenziswayo. Nangona kunjalo, kusekho iingxaki zokuqinisekisa ukuba ii-PDMP zinobuhlobo obusetyenziswa ngumsebenzisi, ziphezulu kakhulu, kwaye azinzima kakhulu kwii-kliniki.

Ukuxhasa Amanyathelo Okuhlaziya Ayingozi

Iindlela zokunciphisa umonakalo ziye zafumana ulwamkelo olukhulayo njengelungu elibalulekileyo lempendulo ye-opioid. Abalawuli belizwe baye benza indima ephambili ekwandiseni ukufikelela kwi-naloxone, iyeza elisindisa ubomi elibuyisela ukusetyenziswa kokusebenzisa i-opioids. Abaninzi baye bakhupha imiyalelo emileyo evumela ii-appcials ukunikezela nge-naloxone ngaphandle kogunyaziso, inkxaso esekelwe kunikezelo lwe-naloxone, kunye namalungu esizwe aqeqeshelwe ukuphendula kuqala kunye namalungu entsapho ekusetyenzisweni kwayo.

Amanye amaphondo aye ahambela phambili ngokuseka iinkqubo zenkonzo yejelo (SSPS), ezinika izixhobo zokutofela izitofu ezizintsholongwane, zinciphisa iHIV kunye nokusasazwa kwesifo sehepatitis C, kwaye zinika amathuba okudibanisa abantu ngonyango. Amazwe ambalwa aye aqhuba iindawo zokusebenzisa iinkonzo ezijoliswe kuwo, apho abantu banokusebenzisa amayeza phantsi kolwalathiso lwezamayeza ukukhusela ukusetyenziswa kweziyobisi ezibulalayo. Ngoxa la manyathelo ahlala ephikisana nezopolitiko, abalawuli besizwe kwiindawo ezinjengeRhode Island, New York, kunye neKhalifoniya aye abatyhalisa phambili njengemiqathango yempilo kawonke wonke.

Utshintsho Olusemthethweni NeJaji Yezaphuli - mthetho Iyasondela

Abaphathi-mikhosi bephondo baphembelela umthetho onokuthi uphinde uguqule indlela ityala elinxulumene ne-opioid elichatshazelwa ngayo nendlela abantu abakhotyokiswe ngayo kwinkqubo yobulungisa obusesikweni. Iijaji ezininzi zityikitye imigaqo ethi "Ilungile iSamariya" ezinika abantu ababiza i-911 ukuba bangangeni nxaxheba ekutshutshisweni xa besebenzisa iziyobisi ezingephi. Ezinye ziye zaxhasa "ii-360-degree" iinkqubo eziye zabuyisela iingcinga-ziyobisi ezisemgangathweni osezantsi ekuphathweni endaweni yokufakwa epakelweni.

Ukongezelela, abaphathi-mikhosi bephondo baye basebenzela ukutshintsha imithetho ebhaliweyo, efana nokulinganisela ubude bexesha kunye nethamo lezigulana ze-opioid zokuqala kwiintlungu eziqatha. Ngoku uninzi lwamazwe lufuna abameli ukuba banike ezinye iindlela zokulawula iintlungu kwaye baxubushe ngeengozi nezigulana. Kwangaxeshanye, amagqwetha jikelele aye alandela iindawo ezibonisa imbali ezibhaliweyo, kuquka isithuthi see-awubhili-waka lama-R36 kunye noGa Johnson & Johnson kunye nabakhuphi basebenzi be-opicopie, ezinika imali yeenkonzo zokukhotribuliso.

Ucelomngeni Olujamelene Nezikhundla Zorhulumente

Phezu kwayo nje imigudu yazo elungileyo, iinkokeli zikarhulumente zijamelene nocelomngeni olukhulu olubangela ukuba umlo ungabi lula nxamnye neengxaki zeopioid.

Imali Elinganiselweyo Nengaxelelwanga

Inkoliso yenkxaso-mali yentsabelo ye-opioid ivela kwimiqathango karhulumente, njenge-State Opioid Refection (SOR) enikezelwa yi-SAMHSA. Noko ke, ezi zibonelelo zisoloko zibekwe umda kwaye zixhomekeke kwiinguqu zobupolitika. Abalawuli belizwe kufuneka bakhuphisane nezinye izinto eziphambili zoqingqo-mali . /ukuxhasa, izibonelelo zempilo, , zenza kube nzima ukugcina ukuthintelwa ixesha elide kunye neenkqubo zonyango. I-opiojoid iza kususwa rhoqo kwiminyaka emininzi kwaye isenokuvela ngemiqathango yokuba isetyenziswe ngokukhawuleza kangakanani.

Inkcaso Nenkcaso Yezobupolitika

Ukukhotyokiswa kuhlala kusemgangathweni, kwaye abalawuli abaninzi bakarhulumente bajongene nomva wengozi xa bebeka amanyathelo omonakalo afana ne-SPS okanye amanxuwa ajongelweyo. Ukuchaswa koluntu, ukunyanzeliswa komthetho, kunye nokungaphumi kwemithetho engqongqo kunakho ukuthintela okanye kulibazise ukuphumeza. Kwanolwando lonyango olusekelwe kubungqina lungajongwa njenge "ukungcakaza" ukusetyenziswa kweziyobisi ngamacandelo kawonke-wonke, ukunyanzela iinkokeli zikarhulumente ukuba zifake imali eninzi kumaziko emfundo kawonke-wonke.

Ukulungelelanisa Impilo Kawonke - wonke Nomthetho

Abaphathi-mikhosi kufuneka basebenzise uxinzelelo phakathi kokunyanga ukukhotyokiswa njengengxaki yempilo nokuphelisa ukunikezelwa kweziyobisi ezingekho mthethweni. Iindlela zokubonelela ezigqithisileyo zingathintela abantu ekufuneni uncedo, ngoxa iinkqubo zobubele zinokubonwa njengezingasebenzi ngokuchasene nabathengisi. Ukufumana umlinganiselo ofanelekileyo kunzima, ingakumbi kumazwe anemiqathango elinganiselweyo kunye nomlinganiselo ophezulu wolwaphulo-mthetho olunxulumene neziyobisi.

Ukwabelana ngogcino-lwazi nokusebenzisana

Inkqubo ye-opioid esebenzayo ixhomekeke kugcino-lwazi oluchanileyo, olufike ngexesha. Noko ke, amasebe ezonyango eMedicaid, iinkqubo ze-PDMP, kunye nokugcinwa komthetho kusoloko kusebenza kwi-silos nezixhobo zokuxhasa izinto ezingangqinelaniyo. Imithetho yemfihlo efana ne-HIPAA ikwathintela ukwabelana ngolwazi. Izigqeba zephondo kufuneka zifakelwe kwiinkcitho zolwazi lwempilo kunye nokudibanisa ulwazi oluthe xhathisa kwiziphumo ezilandelayo kwaye zibone amanqamlezo aqhaqhaqhazelisa (umz., izikhomba ezikwizifefa ze-fa ze-fantanyl).

Amakhaya Neyantlukwano Yasezidolophini

Ingxaki yeOpioid ichaphazela zombini izixeko zasedolophini nasemaphandleni, kodwa iingxaki ziyahluka. Iingingqi zasemaphandleni zisoloko zingenazo izibonelelo zokukhotyokiswa, iinkonzo eziyingozi, kunye nezothutho lukawonke-wonke eziya kwingingqi. Iingingqi zaseOpioid zijongene noxinano oluphezulu lwefentanyl kunye neziyobisi ezingezobugcisa, kwakunye nokungabi namakhaya kunye nokugula okukhoyo okukhoyo. Abalawuli belizwe kufuneka balungise imigaqo-nkqubo yezicwangciso ezahlukileyo .

Ukoyisa Ucelomngeni Ngokuhlaziya Nokusebenzisana

Phezu kwayo nje le miqobo, abalawuli abaninzi bakarhulumente baye babonakalisa ubuchule obubalaseleyo bokwenza izinto nokuzimisela. Baye benza ikhonkthisi edityanisiweyo ekwabelana ngayo ngeyona ndlela ilungileyo, isebenzisana nengeniso efana neyoMbutho weSizwe weOpioid, kwaye isebenzisana ngqo nabantu abachaphazelekayo. Abanye baye bamisela "opidoless premist" ukulungiselela ukuphendula ngaphaya kwamaziko nokuqinisekisa ukuba inkxaso yemali isetyenziswe ngokunempumelelo.

Ubugcisa bunika amathuba amatsha. Iimeko ezininzi zisebenzisa umatshini ukufunda ukuqikelela ukuba zisebenzisa kakhulu ihomoni elishushu kunye nokusasazwa kwento ezijoliswe kuyo. Ezinye zithumele ii-apps ezisebenzisa iselula ezidibanisa abantu neendawo zonyango ngexesha lokwenene. Izilawuli zikarhulumente ezisebenzisa ezo misebenzi zinokuba neziphumo ezingcono ngoovimba abalinganiselweyo.

Uhlolisiso Lwetyala: Amanyathelo Aphumelelayo KaRhulumente

Uhlalutyo lwamazwe akhethekileyo lunika izifundo ezibalulekileyo ngoko kusebenzayo, kunye noko kungenziwayo.

Ohio: Intlanganiso, Impendulo yogcino-lwazi-Drive

IOhio ibikho kwinkcazo yengxaki yeOpioid, isebenzisa amanani abantu abafa ngokugqithisileyo phakathi kweyona iphezulu kwelizwe. Ekuphenduleni kwayo, iGunya uMike DeWine lakhupha "Umvuzo weOhio Opioid" ngo-2019, lisebenzisa i-R3,000 lezigidi ukusuka kuqingqo-mali kunye nentlawulo karhulumente. Iinyathelo ezingundoqo ziquka ukwandiswa kokufikelela kwi-borfunophine kwisebe likaxakeka, ukuxhasa iiyunithi zempilo zenqwelo-mafutha ezifikelela emaphandleni asemaphandleni e-Appola, kunye nokwenza i-opidboard ebanzi "udioid" yokufa, amaphepha-agistra, amaphepha-mvume, kunye nobuchule bonyango. Ilinye elisetyenziswa kakhulu kwi-naxone kunye nokusasazwanomthetho kunye nomthetho kubhekisa kubantu abathile endaweni yokugcinwa kwentolongo. Njengesiphumo, iziphumo sokufa eOhiohiohioki, ngo-202%, kunye neminye ye-202%, kunye neminye ye-20%.

IRhode Island: Ukufudusa Ilizwe Eliyingozi

Rhode Island ithathe indlela eqinileyo ngokudibanisa unciphiso lwengozi kwinkqubo yayo ebanzi yempilo. Phantsi kweRhuluneli uGina Rainondo kwaye kamva iRhuluneli uDan McKee, imo yelizwe yaxhasa umqhubi wesinxulumani wobuvulindlela wesinxulumani senqwelo-moya. "owokuqala) kwilizwe , kwaye wandisa iinkqubo zayo zenkonzo ye-rintineyl ukuquka iipesenti kunye nokukhathalela inxeba. iRhode Island yasebenzisa imodeli "hub kwaye yathetha" imodeli ekwandisa ngokuphawulekayo inani labantu abafumana i-MPY. Ngo-2023, urhulumente wanikela ingxelo yonciphiso lwe 12% kwinani eliphezulu kakhulu xa kuthelekiswa nonyaka ongaphambili.

ENtshona Virginia: Ukuphelisa Iingxaki Zasemaphandleni

INtshona Virginia inenani eliphakamileyo lokufa kwabantu abasebenzisa i-opioid eninzi kakhulu kweli lizwe, kodwa abalawuli belizwe baye bathabatha amanyathelo anzima ukuthetha ngezithuba zokufikelela emaphandleni. IGadala uJim Justice yandisa inkqubo yeMedicaid ukugquma kwaye isebenzisa urhulumente ukunikezela ngemali ukwenza "amaqela aphendulayo" atyelela abasindi abagqithileyo abasetyenziswa kakhulu emakhayeni abo. Ilizwe lakwasungula iqonga elidibanisa abemi basemaphandleni noogqirha abakhotyo eNtshona Virginia. Ngoxa ucelomngeni luye lwanceda ukuphelisa amanani abantu abafayo kunye nokwanda konyango ngeminyaka eli-15%.

Imigaqo yexesha elizayo ukwenzela inyathelo lolawulo lwesizwe

Ingxaki ye-opioid iyaqhubeka iguquka, ngokunyuka kwefentanyl eneepilisi zobuxoki, i-xylazine (isixhobo sokuthomalalisa izilwanyana), kunye nokusetyenziswa kwepolypulanting. Abalawuli belizwe kufuneka bahlale ngaphambi kwezi meko. Izinto eziphambili kwixa elizayo kufuneka ziquke:

  • [[UMTL:0] Ukufakela kwisixokelelwano sokujonga ngexesha lokwenene [[FT:1] okunokufumana izinto ezivelisa uvulo nokuxhobisa izilumkiso zempilo kawonke-wonke.
  • Ukunyusa ulawulo lokusebenzisa i-active (unyango olusekelwe kwinkulungwane) ukuze kuqabuliswe kwaye kusetyenziswe ipolysubstation system, exhaswa luphando olubonisa ukusebenza kwayo.
  • Ukwandisa imisebenzi yokukhotyokiswa ngokuxhasa ngemali iingcali zokuchachacha koontanga, oogqirha, kunye nabancedisi boogqirha ukugunyazisa iMAT.
  • Ukuqinisekisa jikelele [ ukusetyenziswa kwemveliso yengxaki kukhathalelo oluphambili, amasebe kaxakeka, kunye nekliniki zangaphambi kokubeleka.
  • Intsebenziswano edibanisayo yombuso ekuhlolweni kwamayeza kunye nogcino-lwazi lokugcinwa komthetho olunesabelo ekuphazamiseni iinkqubo zokurhwebiswa kweziyobisi.

Iirhuluneli namaqela azo kufuneka ziqhubeke zisenza amabhunga asemthethweni anikezelweyo, axhaswe ixesha elide ukuze kusetyenziswe iinkonzo zokukhotyokiswa, kwaye kungavunyelwa ukuba imali iphambukiswe kuqingqo-mali jikelele. Amaphulo okufundisa abantu ngokubanzi abangela ukuba abantu babe ngamakhoboka kwaye anciphise ihlazo ahlala efuneka ukuze kwakhiwe inkxaso kawonke-wonke.

Isiphelo

Abalawuli belizwe yi-linchpins yaseMelika ephendulayo kwingxaki ye-opioid. Igunya labo kwiinkqubo zempilo, uqingqo-mali, kunye nomthetho libanika amandla akhethekileyo okuguqulela ubungqina kwisenzo, ukusindisa ubomi, kunye nokunciphisa umonakalo wentlalo kunye noqoqosho obangelwa kukukhotyokiswa. Ngelixesha iingxaki ezifana nenkxaso-mali, ihlazo, kunye nenkcaso yezobupolitika ziyaqhubeka, ulawulo olutshayo nolunyulu oluboniswe kumazwe anjenge-Ohio, i-Rhode Island, kunye neNtshona Virginia zibonisa ukuba inkqubela-phambili inokwenzeka.

Njengoko lo bhubhani eqhubeka eguquka, ukuzinikela okuqhubekayo okuvela kubaphathi-mikhosi belizwe, kunye nokusebenzisana namaqumrhu karhulumente, abantu basekuhlaleni, kunye nabagcini-zonyango basekuhlaleni, kuza kuba yimfuneko. Injongo ayikokunciphisa nje ukufa kwabantu abasebenzisa iziyobisi, kodwa kukwakha inkqubo ebanzi, enemfesane, nenamandla ethintela ukukhotyokiswa nokuxhaswa kwabo bonke abantu baseMerika.

Ukuze ufumane ulwazi olungakumbi, bona [[FLT: 0]'isixhobo sesizwe seCD-C uxinzelelo oluphezulu , iGaverala-mikhosi yesizwe i-Opioid Inititive, kunye [[FLT:]] nendlela ka-NPR yokulandelela imali yemali yemali yezwe ye-opioid .