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An evidence-based guide to using cannabis to enhance pain relief safely, effectively, and economically while reducing the risks of opioid addiction Opioid addiction has exploded to epidemic proportions in the U.S. Drug overdose is now the leading cause of accidental death. In 2012, 259 million prescriptions were written for opioids—more than enough to give every American adult their own bottle of pills. Uwe Blesching, author of The Cannabis Health Index, clearly and thoroughly lays out the overwhelming benefits of using cannabis—not only to reduce the nation’s dependence on opioids—but also to manage the craving and withdrawal symptoms of opioid addiction, and especially to address the pain that leads to drug use and addiction in the first place. Citing statistics showing that states allowing legal access to cannabis have seen a 25 percent drop in opioid-related deaths, Blesching explains how precision applications of cannabis can alleviate the mental and emotional aspects of pain by modulating numerous neurotransmitters and their emotional counterparts. He presents a convincing case for the powerful benefits of cannabis in reducing the risks of addiction and overdose, cutting monetary costs, and restoring a sense of balance and control to those who struggle with pain.
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 relationship between chronic pain and addiction Patients with chronic pain understandably seek relief from their distress and discomfort, but many medications that alleviate pain are potentially addictive, and most chronic pain conditions only have a temporary response to opiate analgesic drugs. This volume reviews the fundamental topics that underlie the complex relationships of this controversial domain. The authors review behavioral models and practical methods for understanding and treating chronic pain and addiction including methods to formulate patients with complex comorbidity and screen patients with chronic pain for addictive liability. Finally, the authors describe the current findings from clinical and basic science that illuminate the role of opiates, cannabinoids and ketamine in the treatment of chronic pain. Up to date and comprehensive, this book is relevant to all professionals engaged in the care of patients with chronic pain or addiction and all others interested in these contemporary issues, particularly non-clinicians seeking clarity in the controversy over the best approach to patients with chronic pain.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
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 first foundational text on the clinical use of cannabis and cannabinoid therapies. Despite thousands of years of medical use and an impressive record of safety, versatility, and efficacy, Cannabis sativa has existed outside the modern pharmacopeia since the 1940s. Primarily driven by popular demand, this botanical has returned to health care, but most clinicians lack the knowledge essential for identifying candidates for treatment, guiding patients, maximizing benefit, and minimizing harm. Dustin Sulak provides health care professionals—including physicians, psychologists, pharmacists, and nurses—with an accessible and evidence-based reference that empowers them to intelligently discuss cannabis with their patients and implement cannabis and cannabinoid therapies with confidence. Based on over a decade of clinical experience and an extensive review of the literature, this detailed and scientifically accurate guide includes the history of cannabis in medicine, the foundations of endocannabinoid physiology, the pharmacological effects of cannabis’ myriad active constituents, the clinical utility of its various preparations, and specific strategies and cautions for treating the most common conditions presenting to a cannabis clinician. This guide is an essential resource for practitioners of any specialty field or experience level who wish to improve their patients’ outcomes, harness the healing potential of the endocannabinoid system, and wield a powerful solution to many of healthcare’s challenges.
Getting Wrecked provides a rich ethnographic account of women battling addiction as they cycle through jail, prison, and community treatment programs in Massachusetts. As incarceration has become a predominant American social policy for managing the problem of drug use, including the opioid epidemic, this book examines how prisons and jails have attempted concurrent programs of punishment and treatment to deal with inmates struggling with a diagnosis of substance use disorder. An addiction physician and medical anthropologist, Kimberly Sue powerfully illustrates the impacts of incarceration on women’s lives as they seek well-being and better health while confronting lives marked by structural violence, gender inequity, and ongoing trauma.
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.