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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.
A classic since its first publication nearly 25 years ago, Stoelting's Anesthesia and Co-Existing Disease, 7th Edition, by Drs. Roberta L. Hines and Katherine E. Marschall, remains your go-to reference for concise, thorough coverage of pathophysiology of the most common diseases and their medical management relevant to anesthesia. To provide the guidance you need to successfully manage or avoid complications stemming from pre-existing conditions there are detailed discussions of each disease, the latest practice guidelines, easy-to-follow treatment algorithms, and more. Presents detailed discussions of common diseases, as well as highlights of more rare diseases and their unique features that could be of importance in the perioperative period. Examines specific anesthesia considerations for special patient populations—including pediatric, obstetric and elderly patients. Features abundant figures, tables, diagrams, and photos to provide fast access to the most pertinent aspects of every condition and to clarify critical points about management of these medical illnesses. Ideal for anesthesiologists in practice and for anesthesia residents in training and preparing for boards. Includes brand new chapters on sleep-disordered breathing, critical care medicine and diseases of aging as well as major updates of nearly all other chapters. Covers respiratory disease in greater detail with newly separated chapters on Sleep Disordered Breathing; Obstructive Lung Disease; Restrictive Lung Disease; and Respiratory Failure. Provides the latest practice guidelines, now integrated into each chapter for quick reference.
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.
Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.
The crime was unforgivable. The suspected murderer—unbelievable. One man’s pursuit of justice—unstoppable. The death of promising young pediatric AIDS researcher Eric Miller stunned the Raleigh, North Carolina, community, largely because of the horrific way he was killed. For months, Eric was slowly tortured as arsenic consumed his body. No one thought that Eric Miller’s wife, Ann—an attractive, demure, educated scientist—could be capable of such a horrible crime. No one except for veteran homicide investigator Chris Morgan, a man in the twilight of his career. But from the moment Morgan saw the thirty-year-old widow in the interview room at the police department, he knew he was seeing pure evil. Now, journalist Amanda Lamb details Morgan’s dogged investigation—a quest for the truth that would last four years and see another life taken before Ann Miller’s tangled web of death and deceit finally came to light.
An estimated 69000 people die each year from opioid overdose. Opioid overdose is easily reversed with the opioid antidote naloxone and with basic life support. Such care is generally only available in medical settings, however. These guidelines recommend that people who are likely to witness an opioid overdose, including people who use opioids, and their family and friends should be given access to naloxone and training in its use so that they can respond to opioid overdose in an emergency if a medical response is not available. Naloxone can be injected or administered intra-nasally and has minimal effects in people who have not used opioids. While naloxone administered by bystanders is a potentially life-saving emergency interim response to opioid overdose, it should not be seen as a replacement for comprehensive medical care.
A four-year investigation into the world of synthetic drugs—from black market factories to users & dealers to harm reduction activists—and what it revealed. A deeply human story, Fentanyl, Inc. is the first deep-dive investigation of a hazardous and illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding government agencies that are challenged to combat it. “A whole new crop of chemicals is radically changing the recreational drug landscape,” writes Ben Westhoff. “These are known as Novel Psychoactive Substances (NPS) and they include replacements for known drugs like heroin, cocaine, ecstasy, and marijuana. They are synthetic, made in a laboratory, and are much more potent than traditional drugs” —and all-too-often tragically lethal. Drugs like fentanyl, K2, and Spice—and those with arcane acronyms like 25i-NBOMe—were all originally conceived in legitimate laboratories for proper scientific and medicinal purposes. Their formulas were then hijacked and manufactured by rogue chemists, largely in China, who change their molecular structures to stay ahead of the law, making the drugs’ effects impossible to predict. Westhoff has infiltrated this shadowy world. He tracks down the little-known scientists who invented these drugs and inadvertently killed thousands, as well as a mysterious drug baron who turned the law upside down in his home country of New Zealand. Westhoff visits the shady factories in China from which these drugs emanate, providing startling and original reporting on how China’s vast chemical industry operates, and how the Chinese government subsidizes it. Poignantly, he chronicles the lives of addicted users and dealers, families of victims, law enforcement officers, and underground drug awareness organizers in the United States and Europe. Together they represent the shocking and riveting full anatomy of a calamity we are just beginning to understand. From its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many. “Timely and agonizing. . . . An impressive work of investigative journalism.” —USA Today “Westhoff explores the many-tentacled world of illicit opioids, from the streets of East St. Louis to Chinese pharmaceutical companies, from music festivals deep in the Michigan woods to sanctioned ‘shooting up rooms’ in Barcelona, in this frank, insightful, and occasionally searing exposé. . . . Westhoff’s well-reported and researched work will likely open eyes, slow knee-jerk responses, and start much needed conversations.” —Publishers Weekly “Our 25 Favorite Books of 2019” —St. Louis Post-Dispatch “Best Books of 2019” —Buzzfeed “Best Nonfiction of 2019” —Kirkus Reviews “50 Best Books of 2019” —Daily Telegraph “Best Nonfiction Books of 2019” —Tyler Cowen “Best Books of 2019” —Yahoo Finance
NOW A MAJOR MOTION PICTURE A true story of death, grief and the law from the 2019 winner of the Australia Council Award for Lifetime Achievement in Literature. In October 1997 a clever young law student at ANU made a bizarre plan to murder her devoted boyfriend after a dinner party at their house. Some of the dinner guests-most of them university students-had heard rumours of the plan. Nobody warned Joe Cinque. He died one Sunday, in his own bed, of a massive dose of rohypnol and heroin. His girlfriend and her best friend were charged with murder. Helen Garner followed the trials in the ACT Supreme Court. Compassionate but unflinching, this is a book about how and why Joe Cinque died. It probes the gap between ethics and the law; examines the helplessness of the courts in the face of what we think of as 'evil'; and explores conscience, culpability, and the battered ideal of duty of care. It is a masterwork from one of Australia's greatest writers. Winner of the Ned Kelly Award for Best True Crime 2005 Winner of the ABIA Book of the Year 2004 PRAISE FOR JOE CINQUE'S CONSOLATION "Garner's book is a writer's profound response to a tragedy and to questions about human responsibility over time as well as at precise moments" The Age "This is a work of great passion and of countervailing humanity - a book of witness..." Australian Book Review
THE ESSENTIAL WORK IN TRAVEL MEDICINE -- NOW COMPLETELY UPDATED FOR 2018 As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, practical information about the health challenges posed by travel has never been greater. For both international travelers and the health professionals who care for them, the CDC Yellow Book 2018: Health Information for International Travel is the definitive guide to staying safe and healthy anywhere in the world. The fully revised and updated 2018 edition codifies the U.S. government's most current health guidelines and information for international travelers, including pretravel vaccine recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts. The 2018 Yellow Book also addresses the needs of specific types of travelers, with dedicated sections on: · Precautions for pregnant travelers, immunocompromised travelers, and travelers with disabilities · Special considerations for newly arrived adoptees, immigrants, and refugees · Practical tips for last-minute or resource-limited travelers · Advice for air crews, humanitarian workers, missionaries, and others who provide care and support overseas Authored by a team of the world's most esteemed travel medicine experts, the Yellow Book is an essential resource for travelers -- and the clinicians overseeing their care -- at home and abroad.
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.