UMongameli uDonald Trump usesabise kaningi ngokuthi uzomemezela isimo esiphuthumayo kuzwelonke uma iCongress yenqaba ukukhipha ama-dollar ayizigidi eziyizinkulungwane ezingama-5.7 ukuze kwakhiwe โudonga olukhulu, olukhuluโ wathembisa isisekelo sakhe ngesikhathi ekhankasela ukhetho lwango-2016. Enkulumweni yethelevishini ye-apocalyptic ekuqaleni kukaJanuwari, waze waxwayisa - ngamanga, njengabahloli bamaqiniso embule phakathi nenkulumo - ukuthi i-tsunami yezigebengu eziqinile kanye nezidakamizwa yayihlasela umngcele we-U.S.-Mexican.
Ukuqamba izimo eziphuthumayo zikazwelonke akunanembeza, ikakhulukazi uma kukhona okwangempela okudinga ukunakwa okuphuthumayo.
Nasi isibonelo: kusukela ngo-1999, 400,000 Abantu baseMelika baye bafa ngenxa yokweqisa kwama-opioid, okuhlanganisa nemithi yobuhlungu etholwe ngokusemthethweni ngemiyalelo noma ngokungemthetho, kanye ne-heroin, i-opioid engekho emthethweni. ICenters for Disease Control (CDC) iphawula ukuthi imithi kadokotela yayihilelekile 218,000 zalezo zingozi.
Ngisho nomongameli wabiza umlutha we-opioid ngokuthi "isimo esiphuthumayo sezempilo yomphakathi" ngemuva kokuthi ikhomishini ayiqoke ngoMashi 2017 ikhiphe isitatimende. umbiko ichaza imiphumela yayo esabekayo. Imizamo kaTrump iholele ekutheni iCongress yabele amaRandi ayizigidi eziyizinkulungwane eziyisithupha ($6 billion) ukuze kuliwe nale nkinga ngo-2018 nango-2019, kanti umongameli wafuna enye imali eyizigidigidi eziyisi-7 ngonyaka ka-2019. ] Nokho, kusukela lapho, ukunaka kwakhe sekuphendukele โkusimo esiphuthumayoโ emngceleni neMexico, okufanayo, ngokuqhathanisa, ngokulunywa yizimbuzane endlovu.
Ukuphuthuma kwakhe kokuqala mayelana nobhubhane lwe-opioid kubonakala sengathi sekuphelile, nakuba kungewona umkhuba wakhe wokwenza izimangalo ezingamanga. Emhlanganweni wangoMeyi 2018, ngokwesibonelo, yena limenyezelwe ukuthi, ngenxa yezigidigidi ezingu-6 zamaRandi, โizibalo zehle kakhulu.โ Kodwa-ke, uma umongameli wayeqonde ukufa kwabantu ngokweqile, lokho ayekusho kwakungamanga aluhlaza. Idatha evela ku- CDC bonisa ukuthi, phakathi kuka-2016 no-2017, ukufa kwe-opioid overdose kadokotela kwehle nge-58 nje kusuka ku-17,087 kuya ku-17,029. Ngokuphathelene nokufa kwe-overdose kusuka kuma-opioid azo zonke izinhlobo (kungakhathaliseki ukuthi kusemthethweni futhi kunqunywe udokotela noma akukho emthethweni, njengaku-heroin), kukhuphuke ngo-12%.
Abagxeki beCongressional ukukhokha ukuthi uhla lwezincomo zekhomishini alwenziwanga ngamandla, ikakhulukazi isiphakamiso sikaTrump. $ 340-million sinciphise isabelomali seHhovisi Le-White House leNqubomgomo Kazwelonke Yokulawulwa Kwezidakamizwa, elixhumanisa umkhankaso kahulumeni wokulwa ne-opioid. Futhi uma kubhekwa izinga lobhubhane, Ochwepheshe gcina ukuthi amaRandi ayizigidi eziyizinkulungwane ezingu-6 eminyakeni emibili awasondeli kulokho okudingekayo ukwenza umehluko wangempela.
I-toll ethathwe kusisekelo sikaTrump
Amaphilisi ezinhlungu e-opioid ane-voltage ephezulu ake abhalwa ngokuhlekwa ukuthi โi-hillbilly heroin,โ kodwa leso sithombe sesiphenduke isidala futhi siyadukisa. Nakuba ukusetshenziswa kabi kwemithi enjalo kuvame ukuba ngokulinganayo ephakeme phakathi kwabampofu nasezindaweni ezinokuntuleka kwemisebenzi okuphezulu, manje izikhala amakilasi nezifunda. Ngasekupheleni kweminyaka yawo-1990, ukwanda kokushona kwabantu ngokweqile kwaqala emiphakathini yasemakhaya ecindezelekile ngokomnotho nasemadolobheni amancane - I-Appalachia ngokuqondene. Nokho, kusukela lapho, le nkinga iye yanda amadolobho futhi imizi ezweni lonke.
Noma kunjalo, a strong Ukulungiswa ikhona phakathi kokulutha kwe-opioid, amazinga okufa ngokweqile, nokucindezeleka kwezomnotho, ikakhulukazi emadolobheni amancane kanye izifunda zasemakhaya, kuhlanganise nekaMaine imiphakathi egawula imithi, izindawo ezithembele kuzo ukudoba ngokuhweba, Futhi Appalachian amadolobha amalahle. Ezindaweni zasemaphandleni zaseNew Hampshire, lapho ngichitha ingxenye yonyaka, akuthathi isikhathi eside ukuqala ukuzwa, noma ukuhlangana, abantu abampilo yabo ithuthukiswe ukulutha kwe-opioid. Imiphakathi enjalo yaba yizisulu zokuqala zalomqedazwe ngenxa yokuthi ukuwohloka kwayo kwezomnotho kwabangela ukuphelelwa ithemba, ukuphelelwa ithemba, nokuncipha kokuzethemba. Ngaphezu kwalokho, abantu abaningi bahlushwa ubuhlungu obungapheli, kungakhathaliseki ukuthi izingozi zasemsebenzini noma imisebenzi enzima ngokomzimba.
UMongameli uTrump kufanele anake kakhulu umlutha we-opioid wezwe. Eziningi zezindawo ezishayeke kakhulu ikhaya kubo kanye abavoti abasize ukumkhetha. Emkhankasweni kamongameli wango-2016, waziveza njengompetha wabo, ekhala ngobunzima babasebenzi basefemini, abavukuzi, abagawuli bemithi, nabanye abacindezelwe ukudilizwa noma ukuncishiselwa amaholo nokuhlala emiphakathini lapho imisebenzi eholela kangcono ababethembele kuyo, ngokuvamile. izizukulwane ngezizukulwane, zazinyamalala.
Izibalo Ezimangalisayo
Idatha evela ku Izikhungo zezempilo zikazwelonke kuveza ukuthi ukufa kwe-overdose kuzo zonke izigaba zezidakamizwa ze-opioid - ezisemthethweni nezingekho emthethweni - zenyuka zisuka ku-10,000 ngo-1999 zaya ku-49,068 ngo-2017, nezinombolo ziphakeme ngokuqhubekayo zamadoda. Kodwa ukufa kwe-heroin (15,958 ngo-2017) kumele kufakwe kungxube ngoba ukusetshenziswa kwalowo muthi kanye nama-opioid kadokotela sekuhlangene.
Nakuba ngaphansi kuka-5% walabo abasebenzisa kabi imithi yezinhlungu ze-opioid bakhukhuleka baye ku-heroin, cishe 80% abasebenzisi be-heroin baqala ngokusebenzisa kabi ama-opioid. Ngaphezu kwalokho, bobabili abantu abaxhumeke kulawa maphilisi ezinhlungu kanye nabasebenzisi bezokungcebeleka bavame ukuwahlanganisa ne-heroin ukuze bakhulise ukuphakama kwawo.
Imilutha ivame ukuthembela ku-heroin kuphela lapho ingasakwazi ukuthenga ama-opioid kodwa isafuna ukondla umkhuba wayo futhi iwuyeke.โisifo se-dope.โ (Izimpawu zayo zokuhoxa ezidabukisayo zihlanganisa isicanucanu, ukugodola, nesifo sohudo, kanye nokukhathazeka okukhulu nokwethuka.) Abathengisi be-heroin bakhokhisa ingxenyana ukulungiswa ngakunye kwalokho abahlinzeki abangekho emthethweni bedumile i-oxycodone- futhi hydrocodone-isidingo se-analgesics esisekelwe kwiphilisi ngalinye.
Cabanga nge-Oxycontin. Iphilisi lamamiligremu angu-80 libiza cishe u-$6.00 ekhemisi, kodwa lilingana nalo $80 emgwaqeni. Qhathanisa lokho ne $ 15- $ 20 lokho kuzokutholela i-heroin. Umehluko wamanani ubalulekile. Imilutha eminingi ye-opioid igcina ibeke ingxenye enkulu yeholo layo ekuthengeni amaphilisi ngokungemthetho, iqede ama-akhawunti abo okulondoloza. Ngenxa yalokho, abanye bagcina sebephendukela ekuthengiseni izinto zabo noma izingxenye zemishini ezebiwe, amapayipi namapayipi. ithusi izintambo (okukhona imakethe enkulu emnyama).
Ngeshwa, ngisho nokufa kwe-49,068 ngo-2017 akunikezi isithombe esigcwele. Ukushona okwengeziwe kubangelwa ukuhlanganisa amaphilisi ezinhlungu ne-cocaine (4,184) noma i-benzodiazepines (cishe i-9,000). Yengeza lezo enkingeni futhi ingqikithi yezimpilo ezilahlekile ngenxa yalolu bhubhane kuleli zwe yafinyelela ku-62,252 ngo-2017, unyaka wokugcina esinemininingwane yawo ephelele. Leso sibalo sikhuphuka phezulu nokho uma ufaka cishe ukufa kwabantu abayi-16,000 okubangelwe yi-heroin.
Ukubeka inani eliphelele lokufa okuhlobene ne-opioid ngendlela cabanga ngalokhu: izingozi zezimoto ezibulewe 40,100 abantu ngo-2017. Impi yaseVietnam eyathatha iminyaka eyishumi yaphumela 58,220 Ukufa kwaseMelika. Abantu baseMelika abangaphezu kokuphindwe kahlanu babulawa ama-painkillers anamandla e-opioid ngo-2017 kuphela Ukuhlaselwa kwe-9 / 11 futhi izimpi e-Iraq nase-Afghanistan kuhlangene.
Mayelana nemiphumela yezomnotho, umbiko ka-2017 woMkhandlu kamongameli Wabeluleki Bezomnotho waveza izindleko eziphelele zale nkinga, okuhlanganisa nezinsizakalo zezokwelapha, ukulahleka kweholo kanye nokukhiqiza, kanye nokugcinwa komthetho, ngesikhathi. $ 504 billion e 2015.
Ngamanye amazwi, ngokungafani nalokho kwenzekani emngceleni oseningizimu, lesi akusona isimo esiphuthumayo.
Indlela Eya Ezinhlekeleleni
Ngekhulu leshumi nesishiyagalolunye laseMelika, ama-opiates ayekhona echazwe kabanzi ukwelapha izifo eziningi: izinhlungu zamanxeba noma ekulimaleni okwenziwa omakadebona beMpi Yombango, amajaqamba okuya esikhathini, isifuba somoya, ukukhathazeka, ngisho nezinhlungu zamazinyo ezinsana. Kodwa njengoba odokotela beqaphela ukwanda kwegagasi lokulutheka, uhulumeni wobumbano wabeka imithetho evimbelayo emithini enjalo, eyafinyelela umvuthwandaba ngo-1914. I-Harrison Narcotics Act.
Nakuba lowo mthetho ungazange ukuqede ngokuphelele ukusetshenziswa kwe-opiate, waphawula inguquko. Umbono wezokwelapha ngeke ubuyele embonweni ovumayo wemithi enjalo kuze kube ngawo-1970, ngemva kwalokho amaphilisi ezinhlungu amaningi e-opioid afika emakethe. I-Federal Drug Administration (FDA) igunyaze i-Lortab ku 1982, Vicodin in 1983, MS Contin in 1987, kanye nePercocet in 1999. I-Fentanyl yethulwa okokuqala ngo-1959 futhi ukwahluka kwesikhumba sayo kwathola imvume esemthethweni 1990 yokwelapha ubuhlungu obukhulu.
Ubhubhane lwamanje aluzange luqale ukusimama kwaze kwaba yilapho i-Purdue Pharma, ephethwe umndeni wakwa-Sackler, isungula i-Oxycontin, isidambisi sezinhlungu esisekelwe ku-oxycodone. Ukulandela ukugunyazwa kwe-FDA ku December 1996, yatholakala, ngamandla ahlukahlukene asukela kumamiligremu ayi-10 kuya kwangu-160. Uma kuqhathaniswa nokwelashwa kwe-opioid yangaphambilini, i-Oxycontin yayiseqenjini layo lapho ifika emandleni ayo. Odokotela basheshe baqala ukuyichaza, hhayi abambalwa ngokushiya okumangalisayo: ku isibonelo esisodwa 335,000 kadokotela eminyakeni eyisishiyagalombili. Phakathi neminyaka emihlanu yokuvela kwayo, kwase kunemiyalelo isibhakabhaka kusukela ku-670,000 kuya ku-6.2 wezigidi.
U-Purdue uthe i-Oxy, njengoba yaziwa, yayikhethekile futhi ingcono kunabanduleli bayo ngoba yasebenza ngokukhululwa okunwetshiwe, okuyihora le-12, okuzoqeda ngempumelelo ukulutheka: umuthi ubungeke unikeze ukuphakama okusheshayo noma kufanele kuthathwe njalo. Eqinisweni, ukusebenza komuthi ngokuvamile kwakuncipha kahle mfishane yesikhathi esibekiwe. I-Purdue yakwazi lokhu kodwa yanamathela esicelweni sayo.
Ngo-2001, ukuthengiswa kwe-Oxycontin kwadlula $ 1 billion unyaka. I-boom ayizange izenzekele, kodwa yayikweleta okukhulu ekukhuthazeni umkhiqizo we-Purdue ngentshiseko. Ibutho labamele ukuthengisa, elijutshwe ngemva kokuqeqeshwa ukuze liqinisekise odokotela ngokuphepha nokusebenza komuthi, lalivame ukunikeza labo dokotela ukudla kwamahhala, izipho zamaholide, ama-trinkets, ama-junkets, nokunye. Labo abadayisi abazange baswele isikhuthazo; bamukela amabhonasi amakhulu kugxilwe kubo impumelelo. Abadlali abaphambili bathole imali engaphezu kwamaholo abo onyaka ngemali eyengeziwe.
I-Purdue nayo iqeqeshiwe izinkulungwane odokotela, abahlengikazi, kanye nosokhemisi ezindaweni eziningi ezinhle - konke okuhlelwe futhi kukhokhwa yinkampani - ukusabalalisa izwi lokuthi i-Oxy yayisebenza kahle futhi iphephile, hhayi nje ngokumelene nobuhlungu obukhulu obuvezwa ukuhlinzwa noma ukugula okungapheli kodwa futhi okuvamile. izinhlobonhlobo zobuhlungu obubangelwa, isibonelo, ukulimala emhlane noma isifo samathambo.
Iqhinga labonakala liphumelela ngendlela exakile. Inzuzo yokuthengisa yenyuka ngenxa yokuthi iphilisi lalinqunyelwe kabanzi hhayi nje kuphela yilabo abelapha iziguli ezigulela ukufa, kodwa nodokotela bemindeni asebevele benomthwalo wemfanelo wokwelapha. cishe ingxenye yayo yonke imiyalelo ye-Oxycontin ngo-2003.
Umonakalo Uba Ongenakuphikwa
Odokotela baya ngokuya benikeza i-Oxy ukuthi yelaphe izinhlungu (imvamisa yokulimala okuhlobene nomsebenzi) futhi iziguli zabo zaqala ukulutheka ngokushesha. Bebanjwe isidakamizwa, abanye bazenza ubuhlungu obuqhubekayo emzamweni omkhulu wokuthola izinto ezintsha. โUkuthenga odokotelaโ kwaba yinto evamile futhi. Abanye bantshontshe amaphilisi ezihlotsheni noma kubangani noma bawathenge kubadayisi abangekho emthethweni, okuhlanganisa nalabo abadayisa nge-inthanethi, phakathi kwezinye izindawo, izingosi zokuxhumana ezifana Facebook. Imilutha yayibuye ihogele amaphilisi agayiwe noma iwafake uketshezi bese iwajova ngomjovo, okubeka engcupheni i-Hepatitis B noma C noma i-HIV/AIDS izinaliti ezabiwe. Kanti abanye baphendukela ku-heroin.
Ngokusobala, akuwona wonke umuntu owathatha i-Oxycontin ngenxa yezinhlungu owaba umlutha, ingasaphathwa eyokufa ngenxa yokweqisa izidakamizwa. Kodwa lapho ukulutheka kuqala, kungase konakalise ukuphila, njengoba eminye imilutha ize idlise umkhuba wayo ngobugebengu obuncane noma ubufebe. I izingane yemilutha ngokuvamile ehlushwa ukunganakwa noma ukuphathwa kabi futhi - kulinganiselwa 676,000 kubo ngo-2016 โ noma baba umthwalo wogogo nomkhulu noma bagcina bengenile ukunakekela izingane.
Njengoba ubufakazi benhlekelele banda, abanye odokotela abanesibindi, kanye nezihlobo zabantu abashone ngenxa yokuphuza ngokweqile, baqala ukuhlaba umkhosi. Kodwa i-Purdue yayinomshini we-PR owesabekayo, imali enkulu eyayidingeka ukuze iqashe abameli bezindiza eziphezulu, nokuzimisela ukuzilwela. Ngokuqondene ne-clout eWashington, ingcebo yenkampani kanye nokufinyelela emandleni kudlula kude noma yini izitha zayo ezingase ziqoqwe.
Nokho njengoba igagasi lokulutheka liqala ukukhukhula izwe futhi inani lokufa lenyuka, abacwaningi bezokwelapha baqala ukugqamisa izingozi ezibangelwa i-Oxy futhi bangabaza ukusebenza kwayo kahle uma kuqhathaniswa nama-opioid anamandla amancane. I-FDA, i UMnyango Wezobulungiswa, nabameli bamazwe ahlukahlukene nabo baqala ukunaka. Ngo-2007, kulandela amacala okuthi yehlulekile ukunikeza izexwayiso ezanele mayelana nengozi yokulutha, uPurdue wakhokha. $634.5 million njengengxenye yesivumelwano sokunxeshezelwa nabafunzayo. Abasebenzi bayo abathathu abaphezulu bahlawuliswe isamba semali engu-$34.5 million, okuthengwe yiPurdue (yize bagwema ukuboshwa). Inkampani ngokwayo ayizange ibhekane nanoma yikuphi ukwenza okubi.
Izifundazwe eziningi ziphinde zaqala ukumangalela inkampani, igcizelela ukuthi iyabazi ubungozi bokuluthwa yi-Oxycontin kodwa yenza izimangalo ezidukisayo noma ezingamanga ukuze iphike noma ilulaze ubungozi. Ngo-2007, i-Purdue yaxoxisana nge-$ 19.5 million ukuhlala enezifundazwe ezingama-25 kanye neSifunda sase-Columbia, futhi ngaphandle kokuvuma noma yikuphi ukwenza okubi. Ngo-2015, it zihleliwe neKentucky ngamaRandi ayizigidi ezingama-24. Ngo-2018, ayisithupha izifundazwe eziningi ziqale ukumangalela inkampani.
In 2010, i-FDA igunyaze ukumelana nokulutheka - okungukuthi, okunzima ukuhogela noma ukujova - inguqulo ye-Oxy futhi inguqulo yasekuqaleni yakhishwa emakethe. Njengengxenye yezivumelwano zayo ezingokomthetho, i-Purdue iphinde yavuma ukuyeka ukuphonsa imithi ye-opioid kodokotela futhi yanciphisa abasebenzi bayo abathengisayo.
Hleze uzwe noma yiluphi uzwelo ngesiqhwaga sezemithi esisenkingeni, yazi lokhu: ngo-2001, ukuba umlutha we-oxycodone (i-ejenti esebenzayo ku-Oxycontin) kwase kukhuphuke ngokuphindwe kahlanu. Nokho i-Purdue kanye nongoti bayo abaqashwayo bayibukela phansi ingozi futhi baqhubeka nokuphromotha lesi sidakamizwa ngamandla. NgokoMnyango Wezobulungiswa umbiko, inkampani futhi yazi kusenesikhathi ukuthi umuthi wawuhunyushwa noma ukhishwa uketshezi futhi uyajovwa, kodwa ayizange icabange ukuthi kuwusizo ukudalula izindaba zokuhlukumeza. Ibuye yahlala ebufakazini bayo abaphenyi siqu uqoqwe ngokushushumbiswa kuka-Oxy ngobugebengu kanye namacala odokotela noma izitolo zezidakamizwa eziwukhipha ngokunganaki.
Ngokuqondene nalezo nhlawulo, zaba wushintsho lwenkampani, okwathi ngo-2017 yayisiqongelele. $ 35 billion ngemali engenayo, kakhulu evela ekuthengisweni kwe-Oxycontin e-United States nakwezinye izindawo. Futhi umndeni wakwaSackler? Alikho ilungu layo elake labekwa icala, ingasaphathwa eyokugwetshwa nganoma yini; futhi, ngenani eliphelele $ 14 billion, ngo-2015 baqala ukwenza uhlu lwe-Forbes lwemindeni engu-20 ecebile kakhulu eMelika.
Othile wabanjwa ngecala lezidakamizwa ezingenalo udlame noma ngisho ukweba ezitolo angase abhekane neminyaka yokubhadla ejele, kodwa izikhulu zenkampani ebhekele inhlekelele yezempilo yomphakathi bathole impumelelo emangalisayo.
Yini Next?
Inkinga yamanje ye-opioid idlula i-Purdue. Phakathi kokunye, maningi, imithi ye-opioid enqunywe kabanzi ngaphandle kwe-Oxy, nakuba inani lemithi yonyaka yamaphilisi ezinhlungu ze-opioid inqatshiwe kusukela ngo-2012. Ngokusho a umbiko ekhishwe nguDokotela Jikelele, base bephelele 289 abayizigidi ezingu ngalowo nyaka uma kuqhathaniswa 76 abayizigidi ezingu ngo-1991. I-CDC ibika ukuthi bawile 191 abayizigidi ezingu ngo-2017. Kodwa njengoba i-ejensi iphawula, lokho kusakwenza okumangalisayo 58.7 nemiyalelo kubo bonke abantu abayi-100 e-United States, esele engenantanga ekusetshenzisweni komhlaba wonke kwemithi yezinhlungu ze-opioid.
Kusukela mhlawumbe i-2013, enye inkinga iye yandisa inkinga ye-opioid: ukuhlukunyezwa, ukukhiqizwa okungekho emthethweni, kanye nokushushumbiswa kwe-Fentanyl, i-synthetic opioid analgesic i-potency idlula i-morphine izikhathi ezingama-50 kuye kweziyi-100 kanye ne-oxycodone nge-factory engu-1.5. A amamiligremu amabili umthamo ungabulala.
Ukufa okuxhumene nama-opioid okwenziwa, ikakhulukazi i-Fentanyl, kufinyelelwe 29,406 ngo-2017, ukwanda okuphindwe kasithupha kusukela ngo-2014. I-CDC ithole lokho Fentanyl wathinteka okungenani okuthathu kwesihlanu yokufa kwe-opioid ngokweqile kwe-opioid emazweni angu-10 phakathi nengxenye yokugcina ye-2016 kuphela. Udonga lomuthi kanye nokutholakala okusabalele kusuka izingosi ze-inthanethi ezingekho emthethweni kwandisa kuphela ingozi yokulutheka nokufa. Ngaleso sikhathi, ukufa kwe-heroin ngokweqile, okwaqala ukwanda kakhulu cishe ngesikhathi esifanayo nokufa okuhlobene ne-opioid, kwafinyelela 15,958 ngo-2017 - ukwanda okuphindwe kathathu kusuka ku-2014.
Ukwenza izinto zibe zimbi nakakhulu, ziningi Ama-analogues e-Fentanyl, kuhlanganise 3-Methylfentanyl, inamandla aphindwe kane kuneFentanyl ngokwayo. Nakuba izinsuku zayo zokukhiqiza ezingekho emthethweni zaya kuma-1970, isanda kubuya emgwaqeni nange-inthanethi. Bese kuba khona I-Carfentanil. Isetshenziselwa ukuthulisa izindlovu nezinye izilwane ezinkulu, inamandla izikhathi eziyi-100 kune-Fentanyl futhi nayo, isiqalile ukwenza uphawu olubulalayo. Engxenyeni yokuqala ka-2017, ukufa okuhlobene neCarfentanil kucishe kwaphindeka kabili, kwafinyelela 815. Ibulala kangakanani nje? Ukuthulisa indlovu endala, umthamo ophephile ngu Ama-milligram we-13. Nje .05 amamiligremu azobulala umuntu, ososayensi bayaxwayisa.
Lezo zidakamizwa ezimbili kanye namanye ama-analog e-Fentanyl akhiqizwa futhi athengiswa ngokungemthetho kumanethiwekhi angaphansi e-United States noma ngokuqondile kubasebenzisi abangabodwana. China isibe umthombo oyinhloko walezo zimpahla ezingekho emthethweni. Ngokuphambene nesimangalo sikaMongameli uTrump - njengengxenye yesiphakamiso sakhe "udonga olukhulu, olukhuluphele, oluhleโ โ kuphela a ingxenye encane izidakamizwa ezinjalo ezingekho emthethweni ze-opioid, kuhlanganise ne-heroin, zike zethwe umngcele ziye e-United States ngabantu bokufika abangenazo izincwadi. Inqwaba yalokho okungena nge-Mexico kufihlwa ezimotweni eziwela ezindaweni ezisemthethweni zokungena. Ziningi nezinye izindlela zokushushumbisa. ISenethi umbiko ithole ukuthi isevisi yeposi yase-U.S. isiphenduke umzila ongazi, njengoba senzile abathwali bezentengiselwano njenge-FedEx ne-UPS. Abathengisi abangekho emthethweni baphinde basebenze ngezingosi ze-inthanethi kanye neWebhu Emnyama. Uma kuziwa emithini enjalo, udonga ngeke lwenza mehluko.
Inkinga ye-opioid manje isingene esigabeni esiyingozi nakakhulu. Izibulala-zinhlungu ze-opioid ezinqunywe udokotela ziyi akusenjalo umshayeli wayo oyinhloko, futhi ngisho nalapho benjalo, bavame ukuhlanganiswa ne-cocaine noma i-benzodiazepines. Ngaphezu kwalokho, ngo-2016, i-Fentanyl ne-heroin engekho emthethweni zibaliwe amashumi amabili nantathu yokufa okuhlobene ne-opioid. I-Fentanyl ne-Carfentanil ezikhiqizwe ngokungemthetho futhi zihwetshwe ngokungemthetho kanye nezihlobo zazo zamakhemikhali, ekugcineni, zinciphise inhlekelele ye-Oxycontin.
Futhi izinhlobo ezintsha zamaphilisi ezinhlungu ezinamandla kakhulu ngokungangabazeki zizovela futhi. Thatha i-Dsuvia, ethole imvume ye-FDA ngasekupheleni kuka-2018 phakathi kokuningi impikiswano kudalwe ukwesaba ukulutheka. Inamandla izikhathi ezingu-500 kune-morphine futhi inamandla izikhathi ezingu-10 njenge-Fentanyl. Kuze kube nini ngaphambi kokuthi i-Dsuvia ikhiqize eyayo umlutha nenkinga yokushushumbiswa ngokungemthetho?
Akukho Ukulungisa Okulula
Isimo esiphuthumayo se-opioid sidinga isisombululo esinezici eziningi nesiqhubekayo. Ukwelashwa kokulutheka kuzofanele kube ngcono ngekhwalithi futhi kutholakale ngokulinganayo. Ngenxa yokuthi ukusetshenziswa kabi kwe-opioid kanye nokulutheka kuvame ikakhulukazi ezingxenyeni zezwe ezihlushwa ukuncishiswa kwemisebenzi kanye nemali engenayo ephansi, kuzofanele kube yisizinda sokutshalwa kwezimali komphakathi kanye nokuqeqeshwa kabusha kwemisebenzi. Ukushintshashintsha kokungena kwama-opioid avela phesheya kuzofanele kumiswe ngezinyathelo ezedlula isijeziso. Izinkampani ezibeka impilo yomphakathi engcupheni ngobudedengu bazo kanye nobuciko bazo kufanele zibhekane nokungaphezu komculo we-rap emaquleni.
Ukwengeza, uhlelo lwezepolitiki oluqolwe yimali kanye nama-lobbyists kuzodingeka luvuselelwe. Kusukela ngo-2000 kuya ku-2018, izinkampani ezenza imithi nemikhiqizo yezempilo zisebenzise isamba $ 3.8 billion ukunxenxa abantu eWashington, kuqashwe abagqugquzeli abayi-1,407, abambalwa babo abake basebenza ezindaweni ezahlukene kuhulumeni wobumbano, okuhlanganisa namalungu eCongress. Ngo-2018 kuphela, inani elinikelwe ekunxenxeni izinkampani zemithi ezaziphakathi kwabasebenzisa imali abayishumi abahamba phambili. $ 58 million - futhi lokho akubali $21.8 izigidi eziqoqwe yiPharmaceutical Research and Manufacturers of America (I-PhRMA), emele izinkampani zezidakamizwa ne-biotech.
Uma kubhekwa isikali, izimbangela eziningi, kanye nemiphumela yenkinga ye-opioid, amaRandi ayizigidi eziyizinkulungwane ezingu-6 abekelwe wona akuwona. kude ngokwanele, ngenkathi umnyakazo abaphathi bakaTrump kanye neRepublican Party bewenze ukukhubazeka I-Affordable Care Act izolimaza umzamo kuphela. Ngaleso sikhathi, nsuku zonke, 130 abantu e-United States babulawa ukweqisa kwe-opioid futhi 70% kulabo abalwa nokulutheka abakutholi ukwelashwa isikhathi eside, nakuba kudingekile imithi ziyatholakala.
Ngakho-ke, Mnu. Mongameli, uma ufuna ukubhekana nesimo esiphuthumayo sangempela sikazwelonke futhi uzimisele ukuchitha esinye $ 5.7 billion noma ngaphezulu kakhulu kuphrojekthi ezokwenza, ekugcineni, ikwenze ubukeke kangcono kuwo wonke umuntu, kufaka phakathi isisekelo sakho, uthathe ubhubhane lwe-opioid - futhi ukhohlwe lolo donga olungenamsebenzi.
Rajan Menon, a TomDispatch Njalo, unguSolwazi ka-Anne noBernard Spitzer Wezobudlelwano Bamazwe Ngamazwe e-Powell School, City College of New York, kanye Nocwaningo Olukhulu e-Columbia University's Saltzman Institute of War and Peace Studies. Incwadi yakhe yakamuva ithi Ukuziqhenya Kokungenelela Kwabantu.
Lesi sihloko sivele okokuqala ku-TomDispatch.com, i-weblog ye-Nation Institute, enikeza ukugeleza okuqhubekayo kweminye imithombo, izindaba, kanye nemibono evela ku-Tom Engelhardt, umhleli wesikhathi eside ekushicileleni, umsunguli we-American Empire Project, umbhali we Ukuphela Kwesiko Lokunqoba, njengenoveli, Izinsuku Zokugcina Zokushicilela. Incwadi yakhe yakamuva ithi, A Isizwe Esingenziwanga Ngempi (Haymarket Books).
I-ZNetwork ixhaswa kuphela ngokuphana kwabafundi bayo.
Nikela