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工学人,医用大麻计划参预和受控物质使用的改

2019-08-25 10:04

ARTHUR R WILLIAMS (2018-09-01 to 2020-08-31) Medical Marijuana Program Participation and Changes in Controlled Substance Use. Amount: $238049

THE White House has plan to declare the opioid crisis a national emergency.
[1] This concern is justified: in their legal and illegal forms, opioids kill an American every 16 minutes. Yet a focus on opioids has eclipsed the damage caused by an even deadlier, more common substance. Between 2006 and 2010, an average of 106,765 Americans died each year from alcohol-related causes such as liver disease, alcohol poisoning and drunk driving—more than twice the number of overdoses from all drugs and more than triple the number of opioid overdoses in 2015. Although Americans quaff less alcohol per person than the pub-loving British and Irish or the beer fond Germans, they are drinking far more heavily than they used to.

Is There A Way To Keep Using Opioid Painkillers And Reduce Risk?-有没有办法既能持续使用止痛药还能降低风险?

医用大麻计划参与和受控物质使用的变化

单词注解

死亡,可能源于一个持枪的歹徒,也可能是因为你喝下的一杯酒……

November 13, 20174:48 AM ETAllison Aubrey

Abstract

Project Summary: The United States is experiencing an unprecedented rate of opioid-related overdose death following a dramatic rise in opioid painkiller use over the past 20 years. In response, the CDC, several states, and professional organizations have promoted prescriber guidelines for managing pain with non-opioid alternatives (i.e., anti-inflammatories, anti-depressants). Additional emphasis has focused on reducing the impact of concomitant use of sedating medications (i.e. benzodiazepines) and other controlled substances (i.e. hypnotics, muscle relaxants) that synergistically increase risk of fatal overdose, especially in medically compromised individuals. Recent reports suggest that states with medical marijuana programs have lower rates of opioid overdose death. Possible mechanisms for lower rates of overdose include reductions in opioid use and/or the use of sedating medications due to symptomatic relief of comorbid anxiety or insomnia. However, little is known about the relationship between medical marijuana program participation among patients with pain conditions and changes in use patterns of controlled substance use. Even less is known about the differential impact of specific cannabinoid products medically dispensed (such as high tetrahydrocannabinol [THC] versus high cannabidiol [CBD] products). The New York State medical marijuana program (implemented January 2016) is one of the most highly regulated and medicalized programs in operation in the United States. State-licensed dispensaries must be staffed with licensed pharmacists and demonstrate that they dispense products with consistent cannabinoid ratios (including high-THC, high-CBD, and 1:1 THC:CBD products). New York State is therefore an ideal setting for a rigorous analysis of medical cannabis program participation and the impact of cannabinoid products with varying THC:CBD ratios on controlled substance use over time among chronic pain patients. We propose to partner with the largest medical marijuana provider in New York (> 10,000 participants enrolled as of October 2017). Participant activity is tracked through an electronic health record with de-identified patient characteristics at baseline (demographics, qualifying condition and symptoms, concomitant medications) that is linked to data containing 12-month controlled substance prescription history through the state?s prescription drug monitoring program . The analysis of these de-identified, compiled records is a highly innovative and cost-effective method for better understanding the potential mechanisms of how participation in medical marijuana programs influences controlled substance use and overdose risk among patients with pain conditions receiving opioids and sedative-hypnotics and can inform subsequent prospective study designs.

项目摘要:在过去20年阿片类药物止痛药使用量急剧增加之后,美国正在经历前所未有的阿片类药物相关过量死亡率。作为回应,疾病预防控制中心,几个州和专业组织已经推广了使用非阿片类药物替代品(即抗炎药,抗抑郁药)治疗疼痛的处方指南。另外强调的重点是减少同时使用镇静药物和其他受控物质(即催眠药,肌肉松弛剂)的影响,这些物质协同增加致命过量的风险,特别是在医学上受损的个体。最近的报告表明,拥有医用大麻计划的州的阿片类药物过量死亡率较低。降低过量服用率的可能机制包括减少阿片类药物的使用和/或使用镇静药物,因为症状缓解共患焦虑症或失眠症。然而,对于疼痛状况患者的医用大麻计划参与与受控物质使用的使用模式的变化之间的关系知之甚少。人们对于医学上分配的特定大麻素产品(如高四氢大麻酚[THC]与高大麻酚[CBD]产品)的不同影响知之甚少。纽约州医用大麻计划(2016年1月实施)是美国最受监管和医疗化程度最高的计划之一。国家许可的药房必须配备有执照的药剂师,并证明他们分配的产品具有一致的大麻素比例(包括高THC,高CBD和1:1 THC:CBD产品)。因此,纽约州是一个理想的环境,可以严格分析医疗大麻计划的参与情况以及大麻素产品对慢性疼痛患者随时间控制物质使用的不同THC:CBD比率的影响。我们建议与纽约最大的医用大麻供应商合作(截至2017年10月登记的参与人数超过10,000人)。参与者活动通过电子健康记录进行跟踪,该记录在基线(人口统计学,合格条件和症状,伴随药物)中通过州的处方药监测计划与包含12个月控制物质处方历史的数据相关联的去识别患者特征。对这些去除已识别的汇编记录的分析是一种高度创新且具有成本效益的方法,可以更好地理解参与医用大麻计划如何影响受控物质使用和接受阿片类药物和镇静催眠药的疼痛状况患者过量风险的潜在机制并可以通知随后的前瞻性研究设计。


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图片 1

opioid/ˈəʊpɪˌɔɪd/ 类鸦片活性肽,类鸦片

Maria Fabrizio for NPR

eclipse / ɪ'klɪps /

1.an occasion when the sun or the moon cannot be seen, because the Earth is passing directly between the moon and the sun, or because the moon is passing directly between the Earth and the sun 日食;月食
an eclipse of the sun日食
a total eclipse全食
There will be an eclipse of the moon next month .下个月将会有月食。
2 .[singular 单数] a situation in which someone or something loses their power or fame, because someone or something else has become more powerful or famous 〔权力或名望的〕黯然失色
eclipse sb of achievement 超过某人的成就
He eclipses his elder sister in sports 在体育上,他超过了他的姐姐。
eclipse the sun 日食
Many people expected the growth of television to mean the eclipse of radio.许多人预计电视业的发展会使广播业黯然失色。
3 in eclipse
less famous or powerful than you should beformal 被埋没,湮没无闻 【正式】
Mrs Bosanquet’s novels are now in eclipse.
博赞基特夫人的小说现在已经湮没无闻

Got to give it up

图片 2

overdose / 'əʊvədəʊs /

1 too much of a drug taken at one time 〔药物一次性的〕使用过量
She took an overdose and died two days later.她服药过量,两天后死了。
[ of ]
a massive overdose of heroin严重过量吸食海洛因
2 too much of something, especially something harmful 〔尤指有害之物的〕过量,过多
[ of ]
an overdose of sun暴晒

不能再喝了

Jon McHann, 56, got started on prescription opioids the way a lot of adults in the U.S. did: he was in pain following an accident. In his case, it was a fall.

翻译

美国联邦政府已经计划宣称鸦片危机成为了全国紧急事件。
这个担心是合理的,每16分钟就有一个美国以合法和非合法的形式死于类鸦片。但是,对鸦片类药物的关注已经被一种更致命,更寻常的物质所掩盖。在2006和2010年期间,每年平均有106765的美国人死于与酒精有关的疾病,例如肝病,酒精中毒和酒驾,它超过了所有药物过量的两倍多,而且超过了2015年阿片类药物过量的三倍。尽管美国人的饮酒量要比英国、爱尔兰和德国的啤酒爱好者少,但是他们比以前喝的更多。

Heavy drinking still kills many more people than opioid overdoses.

Jon McHann,56岁,像大多数美国人一样使用处方类止痛药,:他在一次摔倒事故中受伤,伤痛一直伴随着他。

比起阿片类药物过量,酗酒杀死了更多的人。

"I hit my tailbone just right, and created a severebulging disc" that required surgery, McHann says.

【1】THE White House has plans to declare the opioid crisis anational emergency. This concern isjustified: in their legal and illegal forms, opioids kill an American every 16 minutes. Yet a focus on opioids haseclipsedthe damage caused by an evendeadlier, more commonsubstance. Between 2006 and 2010, an average of 106,765 Americans died each year fromalcohol-related causes such asliverdisease, alcoholpoisoningand drunk driving—more than twice the number of overdoses from all drugs and more than triple the number of opioid overdoses in 2015. Although Americansquaffless alcohol per person than the pub-lovingBritishandIrishor the beer-fondGermans, they are drinking far more heavily than they used to.

“我伤到了我的尾骨,造成严重的腰椎间盘突出”并需要手术,McHann说。

opioid:[oʊ'pi:oʊɪd] adj.类鸦片(引起)的 n.类鸦片活性肽

McHann, who lives in Smithville, Tenn., expected to make a full recovery and go back to work as a heavy haul truck driver. But 10 years after his accident, he's still at home.

overdose:[ˈoʊvərdoʊs] (药物等的)过量;致死(或中毒)剂量

McHann,住在史密斯维尔,Tenn.,预计能够完全康复,并回去继续做重载卡车司机。但事故发生10年后,他仍在家中。

national emergency:全国紧急状态

"After the surgery the pain was justexcruciating," McHann recalls. "I was unable to function." His spinal problems turned out to be more complicated and hard to treat. And he developed other health problems, too. He had several more surgical procedures for his back, but he got no relief. He says on days when his pain is through the roof, "I can't open my eyes because I know if I blink it's going to hurt."

justified:[ˈdʒʌstɪfaɪd] adj.有正当理由的,合理的

手术后的疼痛是难以忍受的,”McHann回忆说。”我无法恢复正常身体机能了。”他的脊椎问题变得更加复杂和困难。并且并发了其他健康问题,他的背部经历了几次外科手术,但都没有减轻痛苦,在白天,疼痛能直达头顶,“我不能睁开我的眼睛,因为我知道如果我眨眼就会非常疼痛。

eclipse:[ɪ'klɪps] n. 日或月食;丧失;没落 vt. 形成日或月食;使 ... 黯然失色

His doctor prescribedmethadone, a powerful opioid. He stayed on the drug for seven years.

There will be an eclipse of the moon next month.

他的医生开了一种强效的镇痛类药物美沙酮。他服药七年了。

下月将有月食。

"It helped immensely, it brought my pain down to a 5 or 6 [on a 10 point scale]," McHann says. "I could function fairly well throughout the day. I could go to church every weekend, I could help my wife shop, I could help around the house a little bit."

deadly:[ˈdedli] adj.极端的,非常的;致命的,致死的 adv.极其,非常

“这极大的帮助了我,它能给降低我的痛苦5或6个度[0-10度],”McHann说。”我一整天都能正常工作。我每周末可以去教堂,可以帮助我的妻子购物,也可以在家里转一会儿。

substance:[ˈsʌbstəns] n.物质,材料

McHann knew therisksof opioid drugs, including the risk of dependence. "It was a concern to me," he says. His goal was to get off the drugs. But for many years, it felt like the benefits of the pain relief outweighed the risks.

alcohol:[ˈælkəhɔ:l] n.乙醇,酒精

McHann知道镇痛类药物的风险,包括依赖的风险。“这是我关心的问题,”他说。他的目的是摆脱毒品。但多年来,它感觉就像是痛苦的好处大于风险。

liver:[ˈlɪvə(r)] n.肝脏

图片 3

poision:[ˈpɔɪzn] n.毒药;酒;极糟的食物;极有害的思想(或心情等) vt.毒死;污染

But as concern about the opioid epidemic grew, McHann started getting pushback from his doctors. They began reducing the strength and dose of hisprescription"Every time I saw aclinician, my opioids were reduced," McHann says.

quaff:[kwæf] vt.& vi.一饮而尽;畅饮

但对镇痛类药物的依赖日益增长,McHann开始听从他的医生的建议。他们开始减少他的处方药的强度和剂量“每次我看到一个临床医生,我的镇痛类药物,都减少了,”McHann说。

British:[ˈbrɪtɪʃ] n.(总称)英国人 adj.英国的

As the dosage was decreased, his pain began to increase and he worried that he'd be cut off the drug. "Life wasn't going to be worth living if I couldn't get the pain under control," McHann says.

Irish:[ˈaɪrɪʃ] n.爱尔兰人 adj.爱尔兰的

随着剂量的减少,他的疼痛开始增加,他担心他会有药物截断反应。“如果我不能控制我的痛苦,生活将不会变得有意义”McHann说。

Germans:[ˈdʒɜ:mənz] n.德国人

McHann is not alone; pain is one of the most common and debilitating medical conditions, with about one-third of Americans dealing with some form of acute or chronic pain. In 2014, 3 to 4 percent of adults wereprescribed opioid painkillers long term— 9.6 to 11.5 million people.

白宫计划将阿片类药物危机列为全国紧急状态。这种担忧是正确的:在合法和非法的形式下,阿片类药物每十六分钟就会杀死一个美国人。但对阿片类药物的关注已经超过了对另一类物质危害的关注,这种物质更常见也更致命。2006至1010年间,平均每年有106765个美国人因酒精相关的原因而死,像是肝脏疾病、酒精中毒、醉酒驾驶等,这一数目是2015年全年死于所有药物过量人数的两倍以上,是阿片过量致死人数的三倍还不止。尽管相比于爱泡吧的英国人和爱尔兰人,以及酷爱啤酒的德国人,美国人平均摄入酒精量要少一些,但是他们现在喝酒比自己过去凶得多。

mchann并不孤独;疼痛是一种常见的使人衰弱的疾病,约有三分之一的美国人忍受某些形式的急性的或慢性的疼痛。在2014, 3到4%的美国成年人长期服用止痛药-约960万-1500万人。

[2]On August 9th, researchers found that the share of Americans who are considered “high-risk”tipplers—women who, in any given week, have at least four drinks in a single day, or men who have five drinks—increased by nearly 30% in the period studied.

图片 4

tippler:['tɪplə(r)]:n.酒徒;酒鬼

In response to the epidemic of opioid addiction and deaths, in 2016 the Centers for Disease Control and Prevention released guidelines urging physicians to try non-opioid methods first for chronic pain. In a viewpointpublishedlast month inJAMA, the journal of the American Medical Association, CDC officials wrote that while illicit opioids such as fentanyl seem to be driving the recent increase in opioid-related overdose deaths, "unnecessary exposure to prescription opioids must be reduced to prevent development of opioid use disorder in the first place."

8月9日,研究人员发现,那些被认为高风险的翻车机的美国人中,在任何一周内每天都至少要喝四杯酒的女性,或者是喝五杯酒的男性,研究期间其比例增加了近30%。

为了应对镇痛类药物成瘾和死亡的流行,2016疾病控制和预防中心发布了指导方针,要求医生首先尝试非镇痛类药物来治疗慢性尿路感染。在一个观点在JAMA上个月发表,美国医学协会的期刊上,疾病预防控制中心的官员说,尽管非法镇痛类药物如芬太尼的使用似乎最近有所增加,在与镇痛类药物使用过量的死亡中,必须减少对处方镇痛类药物的不必要使用,以防止镇痛类药物使用问题的发生。

[3]Anne Case and Angus Deaton, two (married) economists at Princeton University, roll alcohol poisonings together with opioid deaths andsuicidesinto what they call "deaths ofdespair". Having sufferedlurchingeconomic and social change, they argue, white folk with high-schooldiplomasor less have turned to opioids and alcohol forcomfort. Suchanguishis what they believeunderpinsa risingmortalityrate among middle-aged white Americans, even as that rate falls in other developed countries. Is the rise in problem drinking part of the same phenomenon?

But figuring out what's unnecessary, and how best to reduce the risk, can be a challenge.

suicide:[ˈsuɪˌsaɪd] n.自杀;自杀行为;;自杀者 vt.自杀 adj.自杀的

但是,搞清楚什么是不必要的,以及如何最好地减少风险,是一个挑战。

despair:[dɪˈsper] n.绝望;使人绝望的人(或事物) vi.绝望

"I have certainly met a good number of patients who have not found better options and are now taking opioids for chronic pain," saysStefan Kertesz, a physician who is a professor at the University of Alabama at Birmingham, certified in addiction medicine.

lurch:[lɜrtʃ]v.倾斜;摇晃;东倒西歪; n.突然倾斜;(突然感到)兴奋或失望

“我遇到一定数量的人还没有找到更好的选择,现在服用阿片类药物治疗慢性疼痛的病人,”Stefan Kertesz说,阿拉巴马州伯明翰大学的教授,并获得成瘾医学认证。

His heart gave a lurch when he saw her.

Kertesz, who is not McHann's doctor, says some physicians feel caught between a rock and a hard place. With the rise in opioid overdose deaths, there's a lot of pressure to limit prescriptions.

他见到她时心怦然一跳。

凯尔泰斯,不是mchann的医生,说一些医生感到陷入进退两难的境地。在镇痛类药物过量会引起的死亡,有很多的压力在限制处方药。

diploma:[dɪˈploʊmə] 毕业文凭;学位证书;公文;奖状

图片 5

She has a diploma in education.

The CDCguidelinespoint to the serious risks of high dosages and long-term use, including addiction. They offerguidanceto physicians on how to taper doses, or discontinue the use of the drugs.

她取得了教育学文凭。

疾病预防控制中心指出了高剂量和长期使用的严重风险,包括成瘾。他们指导医生如何减量剂量,或不连续使用药物。

comfort:[ˈkʌmfərt] 舒适,安慰

Kertesz agrees that opioids have been prescribed too much in the past. "Absolutely, [doctors] caused new addiction in some people by prescribing too aggressively," Kertesz says. "But the idea that you can simply take [the drugs] away, sometimes from people who need them, is mistaken."

anguish:[ˈæŋgwɪʃ] 痛苦;苦恼;伤心

凯尔泰斯认为,“镇痛类药物在过去确实是使用过量了。”当然,[医生]的剂量过大,引起了一些病人成瘾,凯尔泰斯说。“但是你如果只是简单的认为消除成瘾就将镇痛类药物去除,从需要的人那里拿走,这是错误的。”

underpin:[ˌʌndərˈpɪn] 用砖石结构等从下面支撑(墙等);加固(墙等)的基础;加强…的基础

Kertesz' position iscontroversial.His stance led me to wonder whether he had had ever worked for the pharmaceutical companies that promoted these drugs? "I have never worked a day in my life for the pharmaceutical industry and I have no interest in doing it in the future," Kertesz says. "Do I want to be in situation where I'm forced to take people off a medicine that is helping them? No! "

mortality:[mɔ:rˈtæləti] 死亡数,死亡率

凯尔泰斯的立场是有争议的。他的态度使我想知道是否他曾经在制药企业中工作过,推进过这些药物?“我没有一天在医药行业工作过,未来我也不感兴趣,”凯尔泰斯说。“我是不是想在这种情况下,强迫别人服用帮助他们的药?不!”

安妮·凯斯和安格斯·迪顿是普林斯顿大学的两位已婚经济学家,他们将酒精中毒、阿片类死亡和自杀归为“绝望的死亡”。他们认为,那些文化程度高中及以下的白人,遭受着经济动荡和社会变迁,转而从阿片类药物和酒精寻求安慰。他们认为这种痛苦使得美国中年的白人死亡率不断上升,而其他发达国家的死亡率在下降。酗酒中人数的上升是不是属于同样的现象?

Going forward, Kertesz says he hopes that new medications will be developed that will have less potential for addiction, "but I think human suffering is really complicated and doctors need to have the room to make professional decisions — together with their patients — about what works best for them."

[4]Not obviously. Opioid overdoses are killing more white males than any other group. But heavy drinking seems to be increasing most not amongmiddle-agedwhites, but the elderly and certainminoritygroups. Over the period measured by theJAMAstudy, theprevalenceofalcoholismamong Americans over 65 jumped 107%, though from a low base. Among black Americans it rose 93%: a larger share of blacks than whites are now considered to suffer from alcoholism. Women are alsohitting the bottleharder.Whereas5% of women were found to meet thecriteriafor alcoholism in 2001-02, in 2012-13 that number rose to 9%.

在未来,凯尔泰斯说,他希望新的药物将被开发出阿里,成瘾潜力更小,“但我认为,人类的痛苦是非常复杂的,医生需要有与他们的病人一起做专业决策——什么对他们最有效。”

middle-aged:['mɪdl eɪdʒd] adj.中年的;适合于中年人的;具有中年人特点的

As for Jon McHann, last month he had anotherprocedureaimed at easing nerve compression in his back, and for now he's optimistic. His pain is diminished, and he's on a much lower dose of medication. He's taking Percocet, which gives him a lower dose of opioids andacetaminophen. "I'm hoping to be opioid free, I don't know if I'll get there, but I want to try."

minority:[maɪˈnɔ:rəti] 少数;少数民族;未成年

至于Jon McHann,上个月他经历了另一次手术旨在缓解背部的神经压迫,现在他很乐观。他的疼痛减轻了,并且服用了一剂低剂量的药。他服用Percocet,这给了他一个低剂量的镇痛类药物和对乙酰氨基酚。”我希望是能够戒掉药物成瘾性,我不知道我是否做到,但我愿意尝试一下。”

JAMA:Journal of the American Medical Association 美国医学协会杂志

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prevalence:[ˈprevələns] n.流行;盛行;普遍;(疾病等的)流行程度

原文来自  NPR  Maria Fabrizio November 13, 20174:48 AM ETAllison Aubrey

alcoholism:[ˈælkəhɔ:lɪzəm] n.酗酒;酒精中毒

hit the bottle:喝醉酒

After she died he began to hit the bottle.

她死之后,他开始酗酒。

whereas:[ˌweərˈæz] 然而;鉴于

criteria:[kraɪ'tɪərɪə] n.(批评、判断等的)标准,准则( criterion的名词复数 );(criterion的复数)

并不显然。相比于其他组,阿片类药物服用过量造成更多的白人男性死亡。但是大部分酗酒人数的增长不是来自中年白人,而是源于老年人和某些少数群体。美国医学协会的研究测量期间,在美国65岁以上人群酒精中毒的患病率上升了107%,尽管其基数本就不大。在美国黑人中,这个数目上升了93%:现在认为黑人中的酗酒比例大于白人中酗酒比例。女性也在天天醉酒。2001-2002年间女性中被发现达到酒精中毒标准的占比是5%,而2012-2013年间这个数字却上升到了9%。

[5]Previous studies suggest that Americans who drink heavily tend to drink very heavily indeed.Analysisby Phillip Cook, a professor at Duke University’s Sanford School of Public Policy, published in 2007 suggested that whereas 30% of Americans did not drink at all in 2001-02, 10% of Americans—or about 24m—had an average often drinks a day. He believes such habits would not look different today.

analysis:[əˈnælɪsɪs] n.分析,分解

过去的研究表明,那些酗酒的美国人往往都确实喝得非常严重。杜克大学桑福德公共政策学院的教授菲力普·库克2007年发表了一个分析报告。该报告表明表明,尽管2001-2002年间,有30%的美国人根本不喝酒,但10%的,或者说2400万的美国人,平均每天都要喝一杯酒。他认为这样的习惯今天也不会有改变。

[6]Bridget Grant, anepidemiologistat theNIAAAand the JAMA study’s principal author, blames the rise in drinking largely on differentmanifestationsof stress. For women, that pressure mightstem fromtheir increased participation in theworkforce. “It may be that women are finding it difficult to both manage their families and their work, which leads to stress, whichinvitesdrinking,” Dr Grant says.

epidemiologist:[ˌepɪˌdi:mɪ'ɒlədʒɪst] n.流行病学家

NIAAA:National Institute of Alcohol Abuse and Alcoholism 全国防止酒精滥用与酒精中毒研究所

manifestation:[ˌmænɪfeˈsteɪʃn]n.表示,显示;示威

stem from:出于;来自,起源于,由…造成

workforce:[ˈwɜ:rkfɔ:rs] n.全体员工;(国家或行业等)劳动力;劳动大军;劳动人口

invite:[ɪnˈvaɪt] 招致;邀请;请求

布丽奇特·格兰特,全国防止酒精滥用与酒精中毒研究所的流行病学家,美国医学协会杂志的主要作者,认为酗酒人数的增长很大程度归咎于压力的不同表现。对于女性来说,这种压力可能来源于她们在职场中的参与度上升。格兰特医生说:“女性发现她们难以兼顾家庭和事业,这导致了压力,压力又引发了酗酒。”

[7]The upshot is that, for the first time since the early 1970s, the mortality rate associated with alcohol-related liver cirrhosis rose dramatically between 2009 and 2013. The decline in mortality rates related to cardiovascular diseases and stroke— both of which can be brought on by heavy drinking—recently slowed.Mitigating the opioid epidemicis critical, but curbing heavy drinking is just as pressing.

upshot:[ˈʌpʃɒt] n.结果

liver cirrhosis:<医>肝硬化;慢性间质性肝炎

dramatically:[drə'mætɪklɪ] adv.戏剧性地,引人注目地

cardiovascular:[ˌkɑ:diəʊˈvæskjələ(r)] adj.心血管的

stroke:[stroʊk] 中风;击球

mitigating:[ˈmɪtɪgeɪtɪŋ] v.减轻,缓和( mitigate的现在分词 )

epidemic:[ˌepɪˈdemɪk] n.流行病;迅速的传播、生长或发展;风尚等的流行 adj.流行性的;极为盛行的

critical:[ˈkrɪtɪkəl] adj.关键的;批评的,爱挑剔的;严重的;极重要的

curbing:['kɜ:bɪŋ] v.限制,克制,抑制( curb的现在分词 )

pressing:[ˈpresɪŋ] adj.紧迫的,紧急的;迫切的,急迫的;恳切的 n.压,压制

其结果是,2009年至2013年间酒精相关的肝硬化死亡率急剧上升,自上世纪70年代初以来这种现象还是首次出现。心血管疾病和中风的死亡率的下降最近放缓了,这两种疾病都可能由酗酒引发。减少阿片类药物的传播固然重要,但限制酗酒也同样紧迫。

酗酒,是过度饮酒而无法自制。有时酗酒不是因为饮酒者本身多么爱酒,而是如文中所说,将酒作为巨大压力下的发泄。一杯杯下去,或许可以获得片刻的放松和欢愉,但却是以损害健康为代价的。虽说一醉解千愁,醒来之后,所有要面对的事一件也没有消失,自己却未必还有解决的能力。

醉生梦死,醉不能让人生,却可以让人死。

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