Pain Management and the Opioid Epidemic


Book Description

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.




The Opioid Epidemic


Book Description

An incisive, essential guide to understanding one of today's most urgent -- and complex -- problems. The Opioid Epidemic: What Everyone Needs to Know® is an accessible, nonpartisan overview of the causes, politics, and treatments tied to the most devastating health crisis of our time. Its comprehensive approach and Q&A format offer readers a practical path to understanding the epidemic from all sides. Written by two expert physicians and enriched with stories from their experiences on the front lines of this epidemic, this book is a critical resource for any general reader -- and for the individuals and families fighting this fight in their own lives.




Medications for Opioid Use Disorder Save Lives


Book Description

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.




A Public Health Guide to Ending the Opioid Epidemic


Book Description

THE DEFINITIVE GUIDE FOR PUBLIC HEALTH PROFESSIONALS FIGHTING THE OPIOID EPIDEMIC The opioid crisis has devastated families and communities across the United States. Changes in policing and medical practices have been swift, but they've achieved only a modest impact on the fundamental causes of substance misuse and addiction. The necessity for upstream intervention is clear. But what does that look like? A Public Health Guide to Ending the Opioid Epidemic does what only a public health approach can: offer credible, scalable, and empirically supported approaches to uprooting one of society's most pernicious challenges. It systemizes the core tenets of the public health approach to substance misuse and addiction, which alongside clinical approaches (prescription guidelines and monitoring, increased access to overdose-reversal medication, and medication-assisted treatment availability) offers a roadmap for end-to-end response to this diverse problem. Core elements of the public health approach, all covered here in practical terms, include: - How to support community-based, primary prevention of substance misuse and addiction in different settings and populations - How to effectively address the cultural, social, and environmental aspects of health that are driving the current epidemic - How governmental public health agencies play a significant role in responding to the epidemic, both in the field's traditional model of disease surveillance and control and in more directed approaches to health promotion (building community resilience; addressing the impact of adverse childhood events; mitigating the root causes of addiction) These frameworks offer a foundation for understanding, analyzing, and meaningfully impacting the burden of opioid misuse and addiction in any population or setting. A Public Health Guide to Ending the Opioid Epidemic is a roadmap for meaningful change.




A Public Health Guide to Ending the Opioid Epidemic


Book Description

Few contributions to the field concerning the current opioid crisis in the United States focus sufficient attention on the public health aspects of the epidemic and share examples that practitioners can use to prevent opioid use disorder and the broader issues of substance misuse and addiction. A great deal of prior published work has concentrated on health care and clinical perspectives related to the crisis, including developing prescribing guidelines, enhancing prescription drug monitoring programs, scaling up access to overdose reversal medication, and making medication-assisted treatment more widely available nationwide. This text adds to and complements this prior work by addressing the central tenets of the public health approach to the opioid crisis.




Facing Addiction in America


Book Description

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.




Relieving Pain in America


Book Description

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.




Overcoming Opioid Addiction: The Authoritative Medical Guide for Patients, Families, Doctors, and Therapists


Book Description

From a leading addiction expert, a desperately needed medical guide to understanding, treating, and finally defeating opioid use disorder Drug overdoses are now the leading cause of death for Americans under the age of 50, claiming more lives than the AIDs epidemic did at its peak. Opioid abuse accounts for two-thirds of these overdoses, with over 100 Americans dying from opioid overdoses every day. Now Overcoming Opioid Addiction provides a comprehensive medical guide for opioid use disorder (OUD) sufferers, their loved ones, clinicians, and other professionals. Here is expertly presented, urgently needed information and guidance, including: Why treating OUD is unlike treating any other form of drug dependency The science that underlies addiction to opioids, and a clear analysis of why this epidemic has become so deadly The different stages and effective methods of treatment, including detoxification vs. maintenance medications, as well as behavioral therapies How to deal with relapses and how to thrive despite OUD Plus a chapter tailored to families with crucial, potentially life-saving information, such as how to select the best treatment program, manage medications, and reverse an overdose.




Opioids and Pain Relief


Book Description

Presents 14 papers from the second conference sponsored by the John C. Liebeskind History of Pain Collection (held in August of 2000). The conference brought together scientists and historians in order to examine the history of the opioids--opium, morphine, heroin, and others--as a "Janus drug," showing two faces of therapeutics on the one hand and addiction and degradation on the other. The focus is on the use of opioids within medicine and the growth of scientific understanding about them and their impact on human beings.




Death in Mud Lick


Book Description

A New York Times Critics’ Top Ten Book of the Year * 2021 Edgar Award Winner Best Fact Crime * A Lit Hub Best Book of The Year From a Pulitzer Prize–winning investigative reporter at the Charleston Gazette-Mail, a “powerful,” (The New York Times) urgent, and heartbreaking account of the corporate greed that pumped millions of pain pills into small Appalachian towns, decimating communities. In a pharmacy in Kermit, West Virginia, 12 million opioid pain pills were distributed in just three years to a town with a population of 382 people. One woman, after losing her brother to overdose, was desperate for justice. Debbie Preece’s fight for accountability for her brother’s death took her well beyond the Sav-Rite Pharmacy in coal country, ultimately leading to three of the biggest drug wholesalers in the country. She was joined by a crusading lawyer and by local journalist, Eric Eyre, who uncovered a massive opioid pill-dumping scandal that shook the foundation of America’s largest drug companies—and won him a Pulitzer Prize. Part Erin Brockovich, part Spotlight, Death in Mud Lick details the clandestine meetings with whistleblowers; a court fight to unseal filings that the drug distributors tried to keep hidden, a push to secure the DEA pill-shipment data, and the fallout after Eyre’s local paper, the Gazette-Mail, the smallest newspaper ever to win a Pulitzer Prize for investigative reporting, broke the story. Eyre follows the opioid shipments into individual counties, pharmacies, and homes in West Virginia and explains how thousands of Appalachians got hooked on prescription drugs—resulting in the highest overdose rates in the country. But despite the tragedy, there is also hope as citizens banded together to create positive change—and won. “A product of one reporter’s sustained outrage [and] a searing spotlight on the scope and human cost of corruption and negligence” (The Washington Post) Eric Eyre’s intimate portrayal of a national public health crisis illuminates the shocking pattern of corporate greed and its repercussions for the citizens of West Virginia—and the nation—to this day.