美国国家公共电台 NPR Surgeon General Urges More Americans To Carry Opioid Antidote

 

RACHEL MARTIN, HOST:

The opioid crisis continues to ravage¹ many communities in the U.S., so much so that the U.S. surgeon general says Americans should be as prepared to handle an opioids overdose as they would be to administer CPR. Today, the surgeon general is issuing an advisory², urging more Americans to carry the medication naloxone. It's also called NARCAN, and it's the drug first responders used to reverse an opioid overdose. I spoke³ to the U.S. surgeon general, Vice⁴ Admiral Jerome Adams, about why ordinary Americans should be prepared to prevent someone from dying from opioids.

JEROME ADAMS: Over half of the overdoses that are occurring are occurring in homes, and so we want everyone to be armed to respond. We should think of it like an EpiPen or like doing CPR on someone.

MARTIN: Is there any kind of risk in having everyday Americans armed with naloxone? I mean, is it difficult to administer? Are there any risks of administering it incorrectly? Do people need training?

ADAMS: One of the things that we're doing is working with pharmacies⁵, working with providers, working with the American Medical Association and the nursing associations to increase training on how to administer naloxone in homes. But overall - and I'm an anesthesiologist who's administered naloxone many times myself - it is easy to use, and 49 out of 50 states have standing⁶ orders for people to be able to access and use naloxone in the home setting because it is a safe drug where the benefits definitely outweigh⁷ the risk, particularly in the midst of an epidemic⁸.

MARTIN: What about paying for it? I mean, this is a medication that costs around $40 a dose, I think. The company has doubled the price in recent years, one of the primary manufacturers. Some devices that you use to administer naloxone cost as much as $600. And, I mean, there is no limit potentially on what individual pharmaceutical⁹ companies can charge, right?

ADAMS: I've spoken to the president about this personally, and both he and I are determined¹⁰ that the cost of naloxone will not be a barrier to folks being able to have access to it.

MARTIN: How do you ensure that?

ADAMS: Well, there are many different ways. No. 1, the president has asked for and Congress has approved $6 billion in funding to respond to the opioid epidemic - more than has ever been approved in history. There's $50 million in funding that has been allocated¹¹ specifically for naloxone. No. 2, we're working with insurers. Ninety-five percent of people who have insurance coverage¹², including Medicare, Medicaid and TRICARE in the VA, are actually able to get naloxone at little or no copay. And we're working with them to make that copay as small as possible; and then finally, work with Adapt Pharmaceuticals¹³ and Kaleo, the two makers¹⁴ of at-home naloxone, to make it easier for individuals to access naloxone at low or no cost.

MARTIN: What's their incentive¹⁵ to keeping the price low? Will they just do it because you tell them it's the right thing to do?

ADAMS: Well, I hope that that's part of it. I know that these companies - I've met with the presidents, and they want to do the right thing. But also strictly¹⁶ from an economic point of view, unfortunately, there are so many people out there that need naloxone that they are going to make their money one way or the other. And I think they want to do the right thing. They just want to do it in a way that helps them sustain their bottom line. And they can do that. We can cut the price significantly and still make money for them and save lives. And that's what we're trying to do.

MARTIN: Is it possible to incentivize other companies to create generics¹⁷ of naloxone so that there is low-cost competition?

ADAMS: Again, we're looking at all possibilities. But right now, we have two really good FDA-approved products, and we're focused on making them available at low or no cost to as many people as possible. And I think from the federal side, from the insurer side and from the pharmaceutical company side, we've got some great potential to do that in short order.

MARTIN: You describe this measure, making naloxone more readily available, as a tourniquet¹⁸, as a life-saving measure. You acknowledge that the key, though, is figuring out what to do with that person after this emergency crisis. Yes, you can administer this and they can live another day, but how do you make sure that person doesn't overdose 24 hours later?

ADAMS: Well, folks want to say unfortunately in far too many cases that the individual has failed. But when a person is coming in from multiple overdoses, I see that as a system failure. We know addiction¹⁹ is a chronic²⁰ disease, much like diabetes²¹ or hypertension, and we need to treat it the same way. So I'm focused as surgeon general on making sure everyone sees addiction not as a moral failing but as a chronic disease and that we have good, evidence-based treatment, including medication-assisted treatment, available for individuals with a warm handoff right from the overdose. We can't have someone overdose and then send them out onto the streets at 2 a.m. because they're going to run right back into the hands of the local drug dealer²².

MARTIN: Explain that moment, the warm handoff moment.

ADAMS: That warm handoff means that you come in at 3 a.m. in the morning having been resuscitated²³ from an overdose, and we have either an immediate²⁴ access to treatment available for you or what's working well in many places, including Rhode Island where I just visited, is a peer recovery coach, someone who has been through this before and who can speak to you in a language that will resonate and will basically be with you until you can get into recovery.

MARTIN: The Trump²⁵ administration has talked a lot about the opioid crisis, has tried to make it a priority in combating it. The president himself has spoken a lot about law enforcement as a mechanism²⁶ to do that and the need to go hard at drug dealers²⁷. What do you think about that? And what about the dealers who are in the business because they themselves are addicts²⁸?

ADAMS: Well, I can tell you from personal experience, I lived this in Indiana when I was the state health commissioner²⁹ there. We are not going to be able to solve this crisis without the involvement of law enforcement. And I can also tell you from visiting many communities that folks are very concerned about the public safety aspects of this crisis. One neighbor is concerned that their son is overdosing. The other neighbor's concerned that their house is getting broken into. And so it's not either or. It's got to be both. And what I'm focused on is meeting with the attorneys general, meeting with the local law enforcement officials, making sure that if you're dealing³⁰ drugs and you're putting people at risk, you're going to go to jail. But if you have a substance use disorder³¹, that we're going to give you an option to get treatment and hopefully become a productive member of society again.

MARTIN: Vice Admiral Jerome Adams - he is the U.S. surgeon general. Thank you so much for your time, sir.

ADAMS: Thank you so much, Rachel.

(SOUNDBITE OF SLEEP DEALER'S "THE WAY HOME")

1 ravage   

vt.使...荒废，破坏...；n.破坏，掠夺，荒废

参考例句：

• Just in time to watch a plague ravage his village.恰好目睹了瘟疫毁灭了他的村庄。
• For two decades the country has been ravaged by civil war and foreign intervention.20年来，这个国家一直被内战外侵所蹂躏。

2 advisory   

adj.劝告的，忠告的，顾问的，提供咨询

参考例句：

• I have worked in an advisory capacity with many hospitals.我曾在多家医院做过顾问工作。
• He was appointed to the advisory committee last month.他上个月获任命为顾问委员会委员。

3 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

4 vice   

n.坏事；恶习；[pl.]台钳，老虎钳；adj.副的

参考例句：

• He guarded himself against vice.他避免染上坏习惯。
• They are sunk in the depth of vice.他们堕入了罪恶的深渊。

5 pharmacies   

药店

参考例句：

• Still, 32 percent of the pharmacies filled the prescriptions. 但仍然有32%的药剂师配发了这两张药方。 来自互联网
• Chinese herbal pharmacies, and traditional massage therapists in the Vancouver telephone book. 中药店，和传统的按摩师在温哥华的电话簿里。 来自互联网

6 standing   

n.持续，地位；adj.永久的，不动的，直立的，不流动的

参考例句：

• After the earthquake only a few houses were left standing.地震过后只有几幢房屋还立着。
• They're standing out against any change in the law.他们坚决反对对法律做任何修改。

7 outweigh   

vt.比...更重，...更重要

参考例句：

• The merits of your plan outweigh the defects.你制定的计划其优点胜过缺点。
• One's merits outweigh one's short-comings.功大于过。

8 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

9 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

10 determined   

adj.坚定的；有决心的

参考例句：

• I have determined on going to Tibet after graduation.我已决定毕业后去西藏。
• He determined to view the rooms behind the office.他决定查看一下办公室后面的房间。

11 allocated   

adj. 分配的 动词allocate的过去式和过去分词

参考例句：

• The Ford Foundation allocated millions of dollars for cancer research. 福特基金会拨款数百万美元用于癌症研究。
• More funds will now be allocated to charitable organizations. 现在会拨更多的资金给慈善组织。

12 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

13 pharmaceuticals   

n.医药品；药物( pharmaceutical的名词复数 )

参考例句：

• the development of new pharmaceuticals 新药的开发
• The companies are pouring trillions of yen into biotechnology research,especially for pharmaceuticals and new seeds. 这些公司将大量资金投入生物工艺学研究，尤其是药品和新种子方面。 来自《简明英汉词典》

14 makers   

n.制造者，制造商（maker的复数形式）

参考例句：

• The makers of the product assured us that there had been no sacrifice of quality. 这一产品的制造商向我们保证说他们没有牺牲质量。
• The makers are about to launch out a new product. 制造商们马上要生产一种新产品。 来自《简明英汉词典》

15 incentive   

n.刺激；动力；鼓励；诱因；动机

参考例句：

• Money is still a major incentive in most occupations.在许多职业中，钱仍是主要的鼓励因素。
• He hasn't much incentive to work hard.他没有努力工作的动机。

16 strictly   

adv.严厉地，严格地；严密地

参考例句：

• His doctor is dieting him strictly.他的医生严格规定他的饮食。
• The guests were seated strictly in order of precedence.客人严格按照地位高低就座。

17 generics   

n.（产品，尤指药物 ）无厂家商标的，无商标的( generic的名词复数 )

参考例句：

• Pfizer has set up an in-house division to handle such generics. Pfizer已经建立了一个内部机构来处理这些学名药。 来自互联网
• Payers are being more pushy about getting patients to take generics. 药物费用的支付者更倾向于让病人使用非专利药。 来自互联网

18 tourniquet   

n.止血器，绞压器，驱血带

参考例句：

• Twist the tourniquet tighter.把止血带扎紧点。
• The tourniquet should occlude venous and lymphatic return.止血带应阻断静脉及淋巴回流。

19 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

20 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

21 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

22 dealer   

n.商人，贩子

参考例句：

• The dealer spent hours bargaining for the painting.那个商人为购买那幅画花了几个小时讨价还价。
• The dealer reduced the price for cash down.这家商店对付现金的人减价优惠。

23 resuscitated   

v.使（某人或某物）恢复知觉，苏醒( resuscitate的过去式和过去分词 )

参考例句：

• The doctor resuscitated the man who was overcome by gas. 医生救活了那个煤气中毒的人。 来自《现代英汉综合大词典》
• She had been literally rejuvenated, resuscitated, brought back from the lip of the grave. 她确确实实返老还童了，恢复了精力，被从坟墓的进口处拉了回来。 来自辞典例句

24 immediate   

adj.立即的；直接的，最接近的；紧靠的

参考例句：

• His immediate neighbours felt it their duty to call.他的近邻认为他们有责任去拜访。
• We declared ourselves for the immediate convocation of the meeting.我们主张立即召开这个会议。

25 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

26 mechanism   

n.机械装置；机构，结构

参考例句：

• The bones and muscles are parts of the mechanism of the body.骨骼和肌肉是人体的组成部件。
• The mechanism of the machine is very complicated.这台机器的结构是非常复杂的。

27 dealers   

n.商人( dealer的名词复数 )；贩毒者；毒品贩子；发牌者

参考例句：

• There was fast bidding between private collectors and dealers. 私人收藏家和交易商急速竞相喊价。
• The police were corrupt and were operating in collusion with the drug dealers. 警察腐败，与那伙毒品贩子内外勾结。

28 addicts   

有…瘾的人( addict的名词复数 )； 入迷的人

参考例句：

• a unit for rehabilitating drug addicts 帮助吸毒者恢复正常生活的机构
• There is counseling to help Internet addicts?even online. 有咨询机构帮助网络沉迷者。 来自超越目标英语 第3册

29 commissioner   

n.（政府厅、局、处等部门）专员，长官，委员

参考例句：

• The commissioner has issued a warrant for her arrest.专员发出了对她的逮捕令。
• He was tapped for police commissioner.他被任命为警务处长。

30 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

31 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。