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.




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.







Prevention of Substance Use


Book Description

This volume provides a serious examination of substance use prevention research and practice as components of the continuum from health promotion through to prevention and health care in sub-groups and in the general population. Extensive background chapters provide portals into the evolution of the field and the cutting edge research being conducted on the etiology, epidemiology, and genetics of substance use and abuse. The global nature and health burden of substance use and abuse incorporates assessments of the serious problems related to the prevention of legal substance use (i.e., alcohol and tobacco) and how lessons learned in those arenas may apply to the prevention of illicit substance use. Research and practice chapters detail a range of effective evidence-based programs, policies and practices and emerging prevention interventions from the literatures on the family and school contexts in addition to innovations involving mindfulness and the social media. Continued advancements in substance use prevention research, practice, training, and policy are projected. Included among topics addressed are: Progression of substance use to abuse and substance use disorders The tobacco prevention experience: a model for substance use prevention? Policy interventions: intended and unintended influences on substance use Qualitative methods in the study of psychoactive substance use Use of media and social media in the prevention of substance use Supporting prevention science and prevention research internationally The array of research accomplishments and real-world methods presented in Prevention of Substance Use merits the attention of a variety of researchers and practitioners, including public health professionals, health psychologists, and epidemiologists.




The Body Hunters


Book Description

Hailed by John le Carré as “an act of courage on the part of its author” and singled out for praise by the leading medical journals in the United States and the United Kingdom, The Body Hunters uncovers the real-life story behind le Carré's acclaimed novel The Constant Gardener and the feature film based on it. "A trenchant exposé . . . meticulously researched and packed with documentary evidence" (Publishers Weekly), Sonia Shah's riveting journalistic account shines a much-needed spotlight on a disturbing new global trend. Drawing on years of original research and reporting in Africa and Asia, Shah examines how the multinational pharmaceutical industry, in its quest to develop lucrative drugs, has begun exporting its clinical research trials to the developing world, where ethical oversight is minimal and desperate patients abound. As the New England Journal of Medicine notes, “it is critical that those engaged in drug development, clinical research and its oversight, research ethics, and policy know about these stories,” which tell of an impossible choice being faced by many of the world's poorest patients—be experimented upon or die for lack of medicine.




Perioperative Care of the Orthopedic Patient


Book Description

Written by experts at the top-ranked Hospital for Special Surgery in New York, Perioperative Care of the Orthopedic Patient is a comprehensive, multidisciplinary manual providing preoperative considerations, postoperative complications, and guidelines for the anesthetic and medical management of patients undergoing orthopedic surgery. Beginning with chapters covering preoperative evaluations and general principles and practices of perioperative medicine, the book then considers anesthesiologic management in orthopedic surgery and the role of postoperative pain management. This is followed by a section on medical management in specific clinical settings, discussing patients with connective tissue disease, cardiac disease, chronic pulmonary and renal diseases, diabetes and psychiatric and neurological diseases. A fourth section covers specific perioperative problems in orthopedic surgery, such as care of the elderly patient, venous thromboembolism, infection, nutrition, compartment syndrome, and bone health. Finally, the role of allied services, quality improvement and ethics are highlighted, and selected case studies are included to illustrate real-world perioperative issues and management strategies in orthopedic surgery. A comprehensive yet concise reference, Perioperative Care of the Orthopedic Patient will be an invaluable resource for orthopedic surgeons, sports medicine specialists and any professional involved in orthopedic surgery.




Vital Directions for Health & Health Care


Book Description

What can be more vital to each of us than our health? Yet, despite unprecedented health care spending, the U.S. health system is substantially underperforming, especially with respect to what should be possible, given current knowledge. Although the United States is currently devoting 18% of its Gross Domestic Product to delivering medical care¿more than $3 trillion annually and nearly double the expenditure of other advanced industrialized countries¿the U.S. health system ranked only 37th in performance in a World Health Organization assessment of member nations. In Vital Directions for Health & Health Care: An Initiative of the National Academy of Medicine, the U.S. National Academy of Medicine (NAM, formerly the Institute of Medicine), which has long stood as the nation¿s most trusted independent source of guidance in health, health care, and biomedical science, has marshaled the wisdom of more than 150 of the nation¿s best researchers and health policy experts to assess opportunities for substantially improving the health and well-being of Americans, the quality of care delivered, and the contributions of science and technology. This publication identifies practical and affordable steps that can and must be taken across eight action and infrastructure priorities, ranging from paying for value and connecting care, to measuring what matters most and accelerating the capture of real-world evidence. Without obscuring the difficulty of the changes needed, in Vital Directions, the NAM offers an important blueprint and resource for health, policy, and leaders at all levels to achieve much better health outcomes at much lower cost.




Pain Killer


Book Description

Examines OxyContin, the so-called miracle prescription drug that swept the nation but led to overdoes and addiction, providing a look at the multi-billion-dollar pain managment business, its excesses and its abuses.




Wisconsin Insurance Report


Book Description




The Future of Fentanyl and Other Synthetic Opioids


Book Description

Deaths involving synthetic opioids, such as fentanyl, increased from roughly 3,000 in 2013 to more than 30,000 in 2018. This book provides readers with insights intended to improve their understanding of the synthetic opioid problem.