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首页> 外文期刊>Substance Abuse Treatment, Prevention, and Policy >‘ Resurgent’, ‘twin’ or ‘silent’ epidemic? A select data overview and observations on increasing psycho-stimulant use and harms in North America
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‘ Resurgent’, ‘twin’ or ‘silent’ epidemic? A select data overview and observations on increasing psycho-stimulant use and harms in North America

机译：'复活'，'双胞胎'或'沉默'流行病？ 选择数据概述和关于增加心理兴奋剂使用和北美伤害的观察

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In the early 2000s, increasing prevalence of psycho-stimulant (e.g., crack/cocaine, methamphetamine) use and related harms, including severe adverse health outcomes, was observed among - mostly marginalized - populations of persons using illicit drugs in North America, underscoring an urgent need for interventions options towards improved prevention and treatment. By about 2010, however, the ‘opioid crisis’, featuring unprecedented use and public health burden, had accelerated into full force in North America, largely muting attention to the psycho-stimulant issue until recently. Recent surveillance data on drug use and related mortality/morbidity from the present decade has documented a marked resurgence of psycho-stimulant use and harms especially in at-risk populations, commonly in direct combination with opioids, across North America, resulting in a ‘twin epidemic’ comprised of opioids and psycho-stimulants We briefly review select epidemiological data indicators for these developments from the United States and Canada; in the latter jurisdiction, related evidence has been less prevalent and systematic but corroborating the same trends. Evidently, the (widely ongoing) focus on the ‘opioid epidemic’ as a ‘mono-type’ drug problem has become an anachronism that requires urgent and appropriate correction. We then briefly consider existing, evidence-based options for – prevention and treatment – interventions targeting psycho-stimulant use and harms, which are substantially more limited and/or less efficacious than those?available?for problematic opioid use,?while?presenting major gaps and challenges. The observed resurgence of psycho-stimulants may, indirectly, relate to recent efforts towards curtailing (medical) opioid availability, thereby accelerating demand and supply for both illicit opioids and psycho-stimulants. The presently unfolding ‘twin epidemic’ of opioids and psycho-stimulants, combined with limited intervention resources, presents an acute challenge for public health and may crucially undermine actively extensive efforts to reduce opioid-related health harms in North America.
机译：在2000年代初期，在北美使用非法毒品的人群中，观察到增加心理兴奋剂（例如，裂缝/可卡因，甲基苯丙胺）使用和相关伤害，包括严重不良健康结果，包括严重的不良健康结果，并在北美使用非法药物，强调迫切需要干预措施改善预防和治疗的选择。然而，到2010年，“阿片类药物危机”，具有前所未有的使用和公共卫生负担，在北美彻底加速了全力挥动了对心理兴趣问题的关注，直到最近。最近关于药物使用的监测数据和本十年的相关死亡率/发病率已经记录了对心理兴奋剂使用的显着重新训练，特别是在风险群体中，通常与北美的阿片类药物直接联合，导致“双胞胎”流行病由阿片类药物和心理兴奋剂组成，我们简要介绍了从美国和加拿大的这些发展中选择了流行病学数据指标;在后一种司法管辖区内，相关证据不太普遍，系统化，但证实相同的趋势。显然，（广泛的持续）关注“阿片类疫情”，作为“单型”毒品问题已成为一种不合适的纠正。然后，我们简要考虑了现有的基于证据的预防和治疗方案 - 针对心理兴奋剂使用和伤害的干预，这与那些的危害显着限制和/或不那么有效？适用于有问题的阿片类药物，？虽然有问题差距和挑战。观察到的心理兴奋剂的重新训练可以间接地涉及近期缩减（医学）阿片类药物的努力，从而加速非法阿片类药物和心理兴奋剂的需求和供应。目前展开的阿片类药物和心理兴奋剂的“双流行病”，与有限的干预资源相结合，对公共卫生提出了急剧挑战，可能会急剧破坏积极破坏性地广泛努力，以减少北美的阿片类药物危害。

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