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 Pain Epidemic


Book Description

Written by an internationally recognized expert, this book uniquely blends the latest research and understanding of chronic pain with very personal stories, including of the author, his wife, his patients and historical figures.




The Pain Epidemic


Book Description

Internationally-recognized pain expert Don Goldenberg helps readers better understand the intricacies of chronic pain through the lens of personal stories, including his own. One out of three Americans lives with chronic pain. Pain is the number one reason we seek medical care and accounts for 40% of doctor visits. Chronic pain is the most common cause of work loss world-wide. The yearly cost of chronic pain in the United States is between $560-$630 billion, higher than that of heart disease, diabetes and cancer combined. Despite this, physicians and the public are woefully ill-informed about chronic pain. The litany of self-help books available to the public are largely misleading, quick-fix, junk-science. Although there is a major push to better inform primary health-care providers on chronic pain, they have been provided no authoritative treatment of the subject. The Pain Epidemic provides the latest medical information and pathways to better understanding and treatment of chronic pain. Dr. Don Goldenberg, an internationally known expert on pain, here discusses such hot topics as the opioid epidemic, mind/body interactions in chronic pain, and gender bias, as well as the role of cannabis and new potential pain treatment. Interested readers will come away with not only a better understanding of the pain epidemic but of pain itself.




Pain Killer


Book Description

From the Pulitzer Prize–winning New York Times reporter who first exposed the roots of the opioid epidemic and the secretive world of the Sackler family behind Purdue Pharma, Pain Killer is the celebrated landmark story of corporate greed and government negligence that inspired an upcoming Netflix series. “This is the book that started it all. Barry Meier is a heroic reporter and Pain Killer is a muckraking classic.”—Patrick Radden Keefe, author of Empire of Pain Between 1999 and 2017, an estimated 250,000 Americans died from overdoses involving prescription painkillers, a plague ignited by Purdue Pharma’s aggressive marketing of OxyContin. Families, working class and wealthy, have been torn apart, businesses destroyed, and public officials pushed to the brink. Meanwhile, the drugmaker’s owners, Raymond and Mortimer Sackler, whose names adorn museums worldwide, made enormous fortunes from the commercial success of OxyContin. In Pain Killer, Barry Meier tells the story of how Purdue turned OxyContin into a billion-dollar blockbuster. Powerful narcotic painkillers, or opioids, were once used as drugs of last resort for pain sufferers. But Purdue launched an unprecedented marketing campaign claiming that the drug’s long-acting formulation made it safer to use than traditional painkillers for many types of pain. That illusion was quickly shattered as drug abusers learned that crushing an Oxy could release its narcotic payload all at once. Even in its prescribed form, Oxy proved fiercely addictive. As OxyContin’s use and abuse grew, Purdue concealed what it knew from regulators, doctors, and patients. Here are the people who profited from the crisis and those who paid the price, those who plotted in boardrooms and those who tried to sound alarm bells. A country doctor in rural Virginia, Art Van Zee, took on Purdue and warned officials about OxyContin abuse. An ebullient high school cheerleader, Lindsey Myers, was reduced to stealing from her parents to feed her escalating Oxy habit. A hard-charging DEA official, Laura Nagel, tried to hold Purdue executives to account. In Pain Killer, Barry Meier breaks new ground in his decades-long investigation into the opioid epidemic. He takes readers inside Purdue to show how long the company withheld information about the abuse of OxyContin and gives a shocking account of the Justice Department’s failure to alter the trajectory of the opioid epidemic and protect thousands of lives. Equal parts crime thriller, medical detective story, and business exposé, Pain Killer is a hard-hitting look at how a supposed wonder drug became the gateway drug to a national tragedy.




Empire of Pain


Book Description

NEW YORK TIMES BESTSELLER • A NEW YORK TIMES NOTABLE BOOK OF THE YEAR • A grand, devastating portrait of three generations of the Sackler family, famed for their philanthropy, whose fortune was built by Valium and whose reputation was destroyed by OxyContin. From the prize-winning and bestselling author of Say Nothing. "A real-life version of the HBO series Succession with a lethal sting in its tail…a masterful work of narrative reportage.” – Laura Miller, Slate The history of the Sackler dynasty is rife with drama—baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful. The Sackler name has adorned the walls of many storied institutions—Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, but the source of the family fortune was vague—until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis. Empire of Pain is the saga of three generations of a single family and the mark they would leave on the world, a tale that moves from the bustling streets of early twentieth-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d’Antibes to the corridors of power in Washington, D.C. It follows the family’s early success with Valium to the much more potent OxyContin, marketed with a ruthless technique of co-opting doctors, influencing the FDA, downplaying the drug’s addictiveness. Empire of Pain chronicles the multiple investigations of the Sacklers and their company, and the scorched-earth legal tactics that the family has used to evade accountability. A masterpiece of narrative reporting, Empire of Pain is a ferociously compelling portrait of America’s second Gilded Age, a study of impunity among the super-elite and a relentless investigation of the naked greed that built one of the world’s great fortunes.




American Overdose


Book Description

A comprehensive portrait of a uniquely American epidemic -- devastating in its findings and damning in its conclusions The opioid epidemic has been described as "one of the greatest mistakes of modern medicine." But calling it a mistake is a generous rewriting of the history of greed, corruption, and indifference that pushed the US into consuming more than 80 percent of the world's opioid painkillers. Journeying through lives and communities wrecked by the epidemic, Chris McGreal reveals not only how Big Pharma hooked Americans on powerfully addictive drugs, but the corrupting of medicine and public institutions that let the opioid makers get away with it. The starting point for McGreal's deeply reported investigation is the miners promised that opioid painkillers would restore their wrecked bodies, but who became targets of "drug dealers in white coats." A few heroic physicians warned of impending disaster. But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers -- resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.




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.




In Pain


Book Description

NPR Best Book of 2019 A bioethicist’s eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic. Travis Rieder’s terrifying journey down the rabbit hole of opioid dependence began with a motorcycle accident in 2015. Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself. Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system. In Pain is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.




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.




The Opioid Epidemic and Infectious Diseases E- Book


Book Description

Offering timely guidance on the junction of the opioid crisis and infectious diseases, this practical handbook by Dr. Brianna L. Norton provides concise yet comprehensive coverage of a growing patient population. Infectious disease specialists are increasingly seeing patients who previously used opiods and now use intravenous drugs. Many challenges are unique to this patient population, including new and growing infections such as hepatitis C, endocarditis, HIV, and hepatitis B. The Opioid Epidemic and Infectious Diseases is an up-to-date, real-world guide that covers the scope of the problem, management guidelines, and much more. Describes the new landscape of the opioid crisis in the U.S. and its intersection with infectious diseases, including epidemiology, Opioid Use Disorder (OUD) and rural America, and more. Offers practical guidance on (OUD) and infectious co-morbidities like hepatitis C, STDs, endocarditis, HIV, and hepatitis B. Covers prevention, treatment, and harm reduction. Discusses OUD, infectious diseases, and the criminal justice system. Consolidates today’s available information and guidance into a single, convenient resource.