单选题 Humans have never lacked for ways to get wasted. The natural world is full of soothing but addictive leaves and fruits and fungi , and for centuries, science has added them to the pharmacopoeia to relieve the pain of patients. In the past two decades, that"s been especially true. As the Joint Commission on the Accreditation of Healthcare Organizations developed new policies to treat pain more actively, approaching it not just as an unfortunate side effect of illness but as a fifth vital sign, along with temperature, heart rate, respirtory rate and blood pressure, a bounty of new opoids(鸦片类物)has rolled off Big Pharma"s production line.
There was fentanyl , synthetic opioid around since the 1960s that went into wide use as a treatment for cancer pain in the 1990s. That was followed by Oxycodone , a short-acting drug for more routine pain, and after thatcame Oxycontin , a 12-hour formulation of the same powerful pill. Finally came hydrocodone . The government considers hydrocodone a Schedule Ⅲ drug—one with a " moderate or low" risk of dependency , as opposed to Schedule Ⅱ"s, which carry a "severe" risk. Physicians must submit a written prescription for Schedule Ⅱ drugs ; for Schedule Ⅲ"s, they just phone the pharmacy. ( Schedule I substances are drugs like heroin that are never prescribed. ) For patients, that wealth of choices spelled danger.
The result has hardly been surprising. Since 1990, there has been a tenfold increase in prescriptions for opioids in the U. S. , according to the Centers for Disease Control and Prevention (CDCP). In 1990 there were barely 6, 000 deaths from accidental drug poisoning in the U. S. By 2007 that number had nearly quintupled , to 27, 658.
Health officials do not tease out which drug is responsible for every death, and it"s not always possible. "There may be lots of drugs on board, " says Cathy Barber, director of the Injury Control Research Center at the Harvard School of Public Health. "Is it the opioid that caused the death? Or is it the combination of opioid, benzodiazepine and a cocktail the person had?" Still, most experts agree that nothing but the exploding availability of opioids could be behind the exploding rate of death.
Despite such heavy death toil, the suivellance over these popular pills faces regulatory maze . In early 2009, the FDA announced that it was initiating a " risk-evaluation and mitigation strategy". The regulations the FDA is empowered to issue include requiring manufacturers to provide better information to patients and doctors, requiring doctors to meet certain educational criteria before writing opioid prescriptions and limiting the number of docs and pharmacies allowed to prescribe or dispense the drugs. "And with all that, "warns Dr. John Jenkins, director of the FDA"s Office of New Drugs, " we do still have to make sure patients have access to drugs they need. "Any regulations the FDA does impose won"t be announced until 2011 at the earliest and could take a year or more to roll out. That leaves millions of people continuing to fill prescriptions, tens of thousands per year dying and patients in genuine pain wondering when a needed medication will relieve their suffering—and when it could lead to something worse.
单选题 Opoids are drugs ______.
【正确答案】 D
【答案解析】具体细节题
[解析] 本题考查对关键词的理解。文章开篇即提到大自然中存在很多有毒的植物，几个世纪以来，人们将这些植物添加到药典中作药用。近几十年由于对镇痛剂的需求增大，越来越多的鸦片类药物被制造出来。但是这并不能说明鸦片类药物就一定是从大自然中提取出来的，第二段就提到了fentanyl，这是一种synthetic opioid，也就是人工合成的鸦片类药物。因此[A]错误。[B]问题在于过于绝对，鸦片类药物并不是一定会导致上瘾，只有过度服用长期服用才有可能上瘾。[C]错误，根据第二段对于药片等级的划分，可知有的鸦片类药物只是属于第三等级，也就是上瘾风险比较小药物，并不属于危险药物。[D]正确，第一、二段都有提及鸦片类药物起的是镇痛作用。
单选题 The criteria for medicine grading in paragraph 2 is based on ______.
【正确答案】 C
【答案解析】具体细节题
[解析] 本题考查对于第二段细节的理解。第二段里面提到hydrocodone被政府定为第三类药物，也就是产生依赖性风险较小的药物。可见这里的药品分级标准是根据药物的依赖性制定的。[C]正确。[A]具有一定的迷惑性，但是要注意区分drug abuse和drug dependency之间的区别，前者是后者产生的必要条件。[B]和[D]同义，drug tolerance和drug resistance都是耐药性的意思，耐药性指的是长期服用某种药物导致药物效力降低的现象，与对药物的依赖性含义不同。
单选题 The soaring number of death from drug poisoning is due to ______.
【正确答案】 D
【答案解析】因果细节题
[解析] 本题考查对三、四段内容的理解。第三段提到了由于药物泛滥，因偶然药物中毒死亡的人数也在激增。第四段首先是医疗官员的意见，他们认为没有办法给每一次死亡定性，因为导致药物中毒的因素很多，可能并不是某一种药物的作用，而是好几种药物混合起了作用。关键在第四段最后一句话，虽然个案的定性有困难，但是专家还是一致认定如此明显的死亡数量增加一定是与鸦片类药物的泛滥有关系的。[A]和[C]都属于断章取义，混淆了医疗个案和群体案件定性之间的区别。[D]选项中easy access是原文exploding availability的同义改写，正确。[B]无中生有。
单选题 The aim of FDA"s regulation over opoids is to ______.
【正确答案】 B
【答案解析】具体细节题
[解析] 本题考查对最后一段内容的理解。最后一段第一句话就指出虽然鸦片类药物造成的社会影响触目惊心，但是对于它的监督仍然好像是走进了一个迷宫。接着具体介绍了监督管理部门——美国食品与药品管理局的计划，他们在2009年提出要进行监管，但是具体成型要到2011年。而且他们的领导人也指出“无论采取什么监管措施，都必须保证有需求的病人仍然能够买到他们需要的镇痛药”。由此可见[A]是错误，监管的目标并不是要禁止鸦片类药物，而是要通过调查和监管将这种药物的医疗副作用和社会不良影响降到最低。[B]准确。[C]、[D]利用原文内容，设置干扰选项，它们只是FDA提出的监管内容，不能和监管目标混为一谈。
单选题 It can be inferred from the passage that ______.
【正确答案】 A
【答案解析】推理引申题
[解析] 本题是针对全文多处细节内容的推理引申。[A]可根据第一段内容判断出来。第一段提到近几年医疗组织鉴定联合委员会推出了新的政策，要求对病患的疼痛采取更加积极的治疗，并且将疼痛与心率，呼吸频率，血压和体温一起并称作生命五大体征。在这一背景下，医药公司才积极研制并生产出了许多新的鸦片类药物，为这种药物的泛滥埋下隐患。因此[A]正确。[B]错在过于绝对，文中并没有就药物泛滥的原因做出总结，但是我们可以大致判断有这样几个原因：医疗团体和医药公司的推动，医生的不谨慎，药品分级制度的不严谨和监管机构的表现不力等等。[C]无中生有，虽然有这个可能，但是文中并未提及。[D]利用文章最后一句话设置干扰，因为FDA最早要到2011年才能推出监管细则，这样一来作者担心又有很多人会因为药物泛滥而无辜死亡了。这里偷梁换柱，将“药物泛滥”改成了“医疗事故”。