Methadone Hydrochloride

来源：天下财经、新浪医药     整理：清风 近日，为了结在指导美国阿片类药物制造商如何提高销售方面的工作中涉及的刑事调查，麦肯锡咨询公司在弗吉尼亚州一家联邦法院签署了暂缓起诉协议，协议明确如果麦肯锡公司支付6.5亿美元，并在未来5年内遵守必要条件，包括不为受管制的药品和酒类等提供销售、营销和推广服务等，则可以避免遭到检方的刑事起诉。 一、案件背景： 2001年，由普渡公司制作的处方止痛药——奥施康定在全美泛滥。奥施康定具有成瘾性，但普渡公司为了巨额利益，却在宣传上故意隐瞒这一点普渡公司宣传，奥施康定药效可以维持12小时，一天只需要服用两次。 2004年至2019年间，McKinsey与普渡制药在美国签订了75项不同的合同。其中，2013年 McKinsey为其制定Evolve to Excellence计划，通过多种方式提高该药物的销量，其中一个方式就是给处方医生进行电话轰炸，向这些医生宣扬奥施康定无成瘾性，让医生给本不需要止痛药的患者开该药物。 2023年12月29日，咨询公司麦肯锡向美国旧金山联邦法院提交拟议协议，同意支付7800万美元了结美国医疗保险公司和福利计划提出的索赔要求。麦肯锡被控为普渡制药、强生等药企提供销售分析和营销建议，助长阿片类药物流行。 麦肯锡此前已支付超6亿美元解决美国各州检察长提出的阿片类药物诉讼，并在9月同意为地方政府和学区的索赔支付2.3亿美元。  2024年10月17日消息，咨询公司麦肯锡公司将与美国检方达成协议，支付超过5亿美元以解决长期存在的联邦调查问题，麦肯锡公司过去曾帮助阿片类药物制造商提高销售额，据称这导致了致命的成瘾流行病。  2024年12月13日消息，麦肯锡向美国弗吉尼亚州阿宾登联邦法院提交为期5年的暂缓起诉协议，同意支付6.5亿美元，以了结美司法部对其在指导阿片类药物生产商普渡制药如何提高销售额的工作中涉及的刑事调查。 美国弗吉尼亚州西区联邦检察官克里斯托弗 · 卡瓦诺表示，这标志着第一次有管理咨询公司，因其提供的建议导致客户犯罪而被追究刑事责任，也标志着第一次有管理咨询公司，因其助长阿片类药物危机而被追究责任。 麦肯锡咨询公司发表声明称，对自己为普渡制药提供服务“深感抱歉”。 美联社报道称，麦肯锡曾为普渡制药服务15年，并在这段时间内提供了增加阿片类药物营收的策略，检方认为这助长了阿片类药物在美国的泛滥，美国疾控中心数据显示，2018年美国有7万人死于药物过量，到2023年猛增至11.2万人。 二、关于麦肯锡 麦肯锡公司是世界级领先的全球管理咨询公司，由美国芝加哥大学商学院教授詹姆斯·麦肯锡（James O’McKinsey）于1926年在美国创建。 麦肯锡采取“公司一体”的合作伙伴关系制度，在全球44个国家有80多个分公司，共拥有7000多名咨询顾问。 当地时间2023年12月29日，麦肯锡同意向美国保险公司支付7800万美元，了结阿片类药物相关索赔。 三、关于阿片类药物管理 阿片类止痛片是从阿片（罂粟）中提取的生物碱及体内外的衍生物，与中枢特异性受体相互作用，能缓解疼痛，产生幸福感。大剂量可导致木僵、昏迷和呼吸抑制。 阿片类药物主要用于中到重度疼痛治疗，例如癌痛。癌痛治疗的临床经验表明，对一种阿片药发生耐受时，换用另一种药物可能在较低剂量时即达到理想的止痛作用，而副作用较小。 阿片类镇痛药主要包括可待因、双氢可待因、氢吗啡酮、羟考酮、美沙酮、吗啡、芬太尼和哌替啶(度冷丁)等。 反复使用阿片类物质将引起机体耐受成瘾，阿片类物质的成瘾的症状包括渴求、焦虑、心境恶劣、打哈欠、出汗、起鸡皮疙瘩、流泪、流涕、恶心或呕吐、腹泻、痛性痉挛、肌肉疼痛、发热和失眠等。 使用吗啡类物质(如静脉使用)有许多躯体后果，包括乙型肝炎、丙型肝炎、HIV感染、败血症、心内膜炎、肺炎和肺脓肿、血栓性静脉炎及横纹肌溶解，同时心理和社会损害也很明显。 据报告，近年来美国出现严重的芬太尼滥用危机，但其根源完全在于美国自身，特别是对阿片类处方药管制的放松。 2017年10月，美国时任总统特朗普针对芬太尼等阿片类药物滥用问题宣布全国进入公共卫生紧急状况。

THURSDAY, Dec. 19, 2024 -- After years of decline, U.S. life expectancy is finally on the rise again for the first time since 2019, new government research shows. This turnaround was driven in part by a decline in drug overdose deaths, which had risen dramatically as a result of the opioid epidemic, according to a second report from the U.S. Centers for Disease Control and Prevention. That includes the first reduction in OD deaths caused by powerful synthetic opioids like fentanyl and tramadol, researchers said. “The age-adjusted rate for drug overdose deaths involving synthetic opioids other than methadone decreased from 2022 to 2023, the first such decrease since the large increases that began in 2013,” concluded the research team led by Matthew Garnett , an injury epidemiologist and statistician with the CDC’s National Center for Health Statistics (NCHS). “The rate also decreased for deaths involving natural and semisynthetic opioids and heroin between 2022 and 2023,” the team added. Life expectancy at birth in 2023 was 78.4 years for the total population, an increase of 0.9 years from 77.5 in 2022, CDC researchers reported. For men, life expectancy increased 1 year, from 74.8 in 2022 to 75.8 in 2023. Meanwhile, women saw a 0.9-year increase, from 80.2 in 2022 to 81.1 in 2023. “From 2022 to 2023, age-adjusted death rates decreased for 9 of the 10 leading causes of death,” wrote the life expectancy research team led by Elizabeth Arias , a health scientist with the NCHS. Deaths due to heart disease, accidental injury, stroke, respiratory disease, Alzheimer’s disease, diabetes, kidney disease, liver disease and COVID-19 all fell significantly between 2022 and 2023, researchers found. The rate of cancer deaths also went down, but not significantly, the report says. The end of the pandemic likely contributed to the increase in life expectancy, researchers said. “The most notable change was for COVID-19, which dropped from the 4th leading cause in 2022 to the 10th leading cause in 2023,” the researchers wrote. Overall, COVID deaths decreased more than 73% between 2022 and 2023, falling from 44.5 deaths to 11.9 deaths per 100,000, researchers said. A decrease in drug OD deaths also contributed to improved life expectancy. The rate of drug overdose deaths fell from 32.6 per 100,000 in 2022 to 31.3 per 100,000 in 2023, researchers said. Drug OD deaths are considered accidental injury deaths. These results jibe with statistics released last week by the CDC, which reported that drug OD deaths had decreased 17% between July 2023 and July 2024. However, the OD death rate is still 3.5 times what it was in 2003, when 8.9 people for every 100,000 died by drug overdose. Drug OD deaths related to synthetic opioids declined by 2.2% between 2022 and 2023, results show -- the first significant decline in OD deaths related to synthetic opioids like fentanyl since 2003, researchers added. Drug overdose deaths related to natural opioids like morphine, oxycodone and hydrocodone also declined 17.1%, between 2022 and 2023, and OD deaths caused by heroin decreased 33.3%. However, OD death rates for cocaine increased by 4.9% between 2022 and 2023, and OD deaths from stimulants like methamphetamine increased by 1.9%, researchers said. Lastly, infants did not seem to benefit from the declining death rates, researchers found. “The infant mortality rate of 560.2 infant deaths per 100,000 live births in 2023 was not significantly different from the rate in 2022,” the researchers wrote. The ten leading causes of infant death in 2023 -- birth defects, low birth weight, sudden infant death syndrome, unintentional injuries, maternal complications, bacterial sepsis of newborn, cord and placental complications, respiratory distress of newborn, intrauterine hypoxia and birth asphyxia, and diseases of the circulatory system -- accounted for more than 65% of all infant deaths, researchers concluded. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.