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.




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.







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.




The American Disease


Book Description

The American Disease is a classic study of the development of drug laws in the United States. Supporting the theory that Americans' attitudes toward drugs have followed a cyclic pattern of tolerance and restraint, author David F. Musto examines the relationz between public outcry and the creation of prohibitive drug laws from the end of the Civil War up to the present. Originally published in 1973, and then in an expanded edition in 1987, this third edition contains a new chapter and preface that both address the renewed debate on policy and drug legislation from the end of the Reagan administration to the current Clinton administration. Here, Musto thoroughly investigates how our nation has dealt with such issues as the controversies over prevention programs and mandatory minimum sentencing, the catastrophe of the crack epidemic, the fear of a heroin revival, and the continued debate over the legalization of marijuana.




Pathways of Addiction


Book Description

Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.







Discovering Addiction


Book Description

Discovering Addiction brings the history of human and animal experimentation in addiction science into the present with a wealth of archival research and dozens of oral-history interviews with addiction researchers. Professor Campbell examines the birth of addiction science---the National Academy of Sciences's project to find a pharmacological fix for narcotics addiction in the late 1930s---and then explores the human and primate experimentation involved in the succeeding studies of the "opium problem," revealing how addiction science became "brain science" by the 1990s. Psychoactive drugs have always had multiple personalities---some cause social problems; others solve them---and the study of these drugs involves similar contradictions. Discovering Addiction enriches discussions of bioethics by exploring controversial topics, including the federal prison research that took place in the 1970s---a still unresolved debate that continues to divide the research community---and the effect of new rules regarding informed consent and the calculus of risk and benefit. This fascinating volume is both an informative history and a thought-provoking guide that asks whether it is possible to differentiate between ethical and unethical research by looking closely at how science is made. Nancy D. Campbell is Associate Professor of Science and Technology Studies at Rensselaer Polytechnic Institute and the author of Using Women: Gender, Drug Policy, and Social Justice. "Compelling and original, lively and engaging---Discovering Addiction opens up new ways of thinking about drug policy as well as the historical discourses of addiction." ---Carol Stabile, University of Wisconsin--Milwaukee Also available: Student Bodies: The Influence of Student Health Services in American Society and Medicine, by Heather Munro Prescott Illness and the Limits of Expression, by Kathlyn Conway White Coat, Clenched Fist: The Political Education of an American Physician, by Fitzhugh Mullan




Blitzed


Book Description

A New York Times bestseller, Norman Ohler's Blitzed is a "fascinating, engrossing, often dark history of drug use in the Third Reich” (Washington Post). The Nazi regime preached an ideology of physical, mental, and moral purity. Yet as Norman Ohler reveals in this gripping history, the Third Reich was saturated with drugs: cocaine, opiates, and, most of all, methamphetamines, which were consumed by everyone from factory workers to housewives to German soldiers. In fact, troops were encouraged, and in some cases ordered, to take rations of a form of crystal meth—the elevated energy and feelings of invincibility associated with the high even help to account for the breakneck invasion that sealed the fall of France in 1940, as well as other German military victories. Hitler himself became increasingly dependent on injections of a cocktail of drugs—ultimately including Eukodal, a cousin of heroin—administered by his personal doctor. Thoroughly researched and rivetingly readable, Blitzed throws light on a history that, until now, has remained in the shadows. “Delightfully nuts.”—The New Yorker




Treatment Improvement Protocol (TIP) 63: Medications for Opioid Use Disorder


Book Description

This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration (FDA)-approved medications used to treat opioid use disorder (OUD)—methadone, naltrexone, and buprenorphine—and provides guidance for healthcare professionals and addiction treatment providers on appropriate prescribing practices for these medications and effective strategies for supporting the patients utilizing medication for the treatment of OUD. The goal of treatment for opioid addiction or OUD is remission of the disorder leading to lasting recovery. Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. This TIP also educates patients, families, and the general public about how OUD medications work and the benefits they offer. Related products: Medication-Assisted Treatment of Opioid Use Disorder: Pocket Guide A Shared Burden: The Military and Civilian Consequences of Army Pain Management Since 2001 Click our Alcoholism, Smoking & Substance Abuse collection to find more resources on this topic.