Canadian journal of public health = Revue canadienne de santé publique
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Can J Public Health · May 2008
Non-medical use of prescription opioids and public health in Canada: an urgent call for research and interventions development.
While the public health problem of psychoactive drug use is well recognized, the emerging phenomenon of non-medical use of prescription opioids has been largely ignored in Canada. Most evidence on this issue and related harms in North America to date come from the United States (US), where the prevalence of non-medical opioid use in key populations, as well as related morbidity and mortality, recently have risen substantially. ⋯ However, a comprehensive assessment of the problem of non-medical prescription opioid use is hindered by the spotty--or absent--nature of crucial indicators and data. We urge that the necessary efforts and resources for systematic assessment of the evolving phenomenon of non-medical opioid use and its key facets be established in Canada, and that policy-makers implement sensible intervention strategies targeting this problem within a public health framework, specifically avoiding unintended negative consequences (e.g., undermining access to pain treatment).
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Can J Public Health · May 2008
What's public? What's private? Policy trade-offs and the debate over mandatory annual influenza vaccination for health care workers.
Policy decisions about public health services differ from those for personal health services. Both require trade-offs between such policy goals as liberty, security, efficiency, and equity. In public health, however, decisions about who will approve, pay for, and deliver services are often accompanied by decisions on when and how to compel individual behaviour. ⋯ Proponents assert less worker absenteeism (efficiency) while opponents stress coercion and alternate personal infection control measures (liberty and individual rights/responsibilities). Consequently, stakeholders talk past each other. Determining the place of mandatory influenza vaccination for health care workers thus demands reconciling policy trade-offs and clarifying the underlying disputes hidden in the language of the policy debate.