标题：The effectiveness of changes to drug policy, regulation and legislation for reducing harms associated with opioids and supporting their medicinal use in Australia, Canada and the UK: A systematic review
摘要：Governments and health agencies in Australia, Canada and the United Kingdom (UK) have implemented changes to drug policy, regulation and/or legislation for reducing increasing rates of dependency, overdose and other harms associated with prescription and over-thecounter opioid drugs, and supporting their medicinal use. However, there has been no systematic evaluation of empirical evidence on the effectiveness of the drug policy changes. A systematic review of studies was conducted to assess the evidence. Studies included peerreviewed and grey literature. The findings of studies were synthesised to identify common features and outcomes of changes to drug policy, including reductions in overdose, death and other indicators of effectiveness. There were 21 studies that met review criteria, and were of changes that generally aimed to: increase access to treatment for issues with opioid drugs; or, restrict access to opioids and other drugs. The evidence base was limited, and overall showed no major impacts in reducing harms and supporting medicinal use. However, studies of changes focused on increasing access to naloxone suggested the most promising evidence of effectiveness. More research and evaluation is required. With the risk of increased harms associated with opioid drug use in Australian, Canadian and United Kingdom settings, policymakers and other stakeholders need to prioritize measures that support: more research and evaluation; national campaigns publicising awareness of risks associated with opioid drug use and their appropriate medicinal use; and investment in health care services offering more appropriate clinical management of pain and opioid drugs.
