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.







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.




SNI


Book Description







The Ego and the ID


Book Description

In his later work, Freud proposed that the human psyche could be divided into three parts: Id, ego and super-ego. Freud discussed this model in the 1920 essay Beyond the Pleasure Principle, and fully elaborated upon it in The Ego and the Id (1923), in which he developed it as an alternative to his previous topographic schema (i.e., conscious, unconscious and preconscious). The id is the completely unconscious, impulsive, childlike portion of the psyche that operates on the "pleasure principle" and is the source of basic impulses and drives; it seeks immediate pleasure and gratification. Freud acknowledged that his use of the term Id (das Es, "the It") derives from the writings of Georg Groddeck. The super-ego is the moral component of the psyche, which takes into account no special circumstances in which the morally right thing may not be right for a given situation. The rational ego attempts to exact a balance between the impractical hedonism of the id and the equally impractical moralism of the super-ego; it is the part of the psyche that is usually reflected most directly in a person's actions. When overburdened or threatened by its tasks, it may employ defense mechanisms including denial repression, undoing, rationalization, repression, and displacement. This concept is usually represented by the "Iceberg Model". This model represents the roles the Id, Ego, and Super Ego play in relation to conscious and unconscious thought. Freud compared the relationship between the ego and the id to that between a charioteer and his horses: the horses provide the energy and drive, while the charioteer provides direction.




Determinants of Health


Book Description

This collection of Michael Grossman’s most important papers adds essential background and depth to his work on economic determinants of public health. Each of the book’s four sections includes an introduction that contextualizes the issues and addresses the larger stakes of his work. An afterword discusses the significance of Grossman’s approach for subsequent research on health economics, as well as the work others have done to advance and extend his innovative perspective. Determinants of Health explains how the economic choices people make influence health and health behaviors. It begins with a section on the theoretical underpinnings and empirical results of Grossman’s groundbreaking health economics model, first introduced in the 1970s, followed by essays on the relationship between health and schooling; determinants of infant health, with a special emphasis on public policies and programs; and the economics of unhealthy behaviors. Grossman treats health as a form of human capital. He shows that public policies and programs that determine the price and availability of key inputs have critical effects on outcomes ranging from birth weight and infant mortality to cigarette smoking, alcohol abuse, illegal drug use, and obesity. Grossman’s approach has led to a major stream of literature in the field, sparking contributions by the world’s leading health economists, including Joseph Newhouse, Jonathan Gruber, Amy Finkelstein, Michael Greenstone, and David Cutler. His clarity on the role that economics play in people’s good and bad health choices is immensely valuable to the debate over how we legislate and spend on health.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




What Determines Harm from Addictive Substances and Behaviours?


Book Description

The multifaceted nature of harmful substance use and gambling requires interdisciplinary analysis to assess the underlying causes. What Determines Harm from Addictive Substances and Behaviours? draws together evidence from twelve disciplines including anthropology, genetics, neurobiology, and public policy. Using a developmental approach, the book presents evidence on the factors that influence the development of harmful substance use and gambling. The determinants of harm operate at three levels: molecular, individual, and social. This book brings to light the complex interplay between them and presents the scientific, social, economic, political, and psychological influences of harmful substance use and gambling. These individual determinants are then synthesised into an integrative heuristic model to encourage new ways of thinking. The findings from this analysis are used to elaborate key general implications for health and broader social policy, clinical practice, and future research. What Determines Harm from Addictive Substances and Behaviours? is based on research from ALICE RAP, a multidisciplinary European study of addictive substances and behaviours in contemporary society. This is an essential resource for public health professionals, stakeholders influencing policy for addictive substances and behaviours, students, and academics looking to better understand the factors influencing substance use and gambling and the implications this research has for addiction prevention policy.