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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.
Revised and updated edition that analyses how the Office of National Drug Control Policy employs statistics to misleadingly claim the War on Drugs is a success. First published in 2007, Lies, Damned Lies, and Drug War Statistics critically analyzed claims made by the Office of National Drug Control Policy (ONDCP), the White House agency of accountability in the nation’s drug war since 1989, as found in the six editions of the annual National Drug Control Strategy between 2000 and 2005. In this revised and updated second edition of their critically acclaimed work, Matthew B. Robinson and Renee G. Scherlen examine seven more recent editions (2006–2012) to once again determine if ONDCP accurately and honestly presents information or intentionally distorts evidence to justify continuing the drug war. They uncover the many ways in which ONDCP manipulates statistics and visually presents that information to the public. Their analysis demonstrates a drug war that consistently fails to reduce drug use, drug fatalities, or illnesses associated with drug use; fails to provide treatment for drug-dependent users; and drives up the prices of drugs. They conclude with policy recommendations for reforming ONDCP’s use of statistics, as well as how the nation fights the war on drugs. Praise for the First Edition “Lies, Damned Lies, and Drug War Statistics is surprisingly easy to read, and Robinson and Scherlen have done a huge favor not only to critics of current drug policy by compiling this damning critique of ONDCP claims, but also to anyone interested in how data is compiled, presented, and misused by bureaucrats attempting to guard their domains. It should be required reading for members of Congress.” — Drug War Chronicle Book Review “The authors have performed a valuable service to our democracy with their meticulous analysis of the White House ONDCP public statements and reports. They have pulled the sheet off what appears to be an official policy of deception using clever and sometimes clumsy attempts at statistical manipulation. This document, at last, gives us a map of the truth.” — Mike Gray, author of Drug Crazy: How We Got into This Mess and How We Can Get Out “Robinson and Scherlen make a valuable contribution to documenting how ONDCP fails to live up to basic standards of accountability and consistency.” — Ethan Nadelmann, Executive Director, Drug Policy Alliance
Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.
"An extensive overview of the drug trade in the Americas and its impact on politics, economics, and society throughout the region. . . . Highly recommended."--Choice "A first-rate update on the state of the long-fought hemispheric 'war on drugs.' It is particularly timely, as the perception that the war is lost and needs to be changed has never been stronger in Latin and North America."--Paul Gootenberg, author of Andean Cocaine: The Making of a Global Drug "A must-read volume for policy makers, concerned citizens, and students alike in the current search for new approaches to forty-year-old policies largely considered to have failed."--David Scott Palmer, coauthor of Power, Institutions, and Leadership in War and Peace "A very useful primer for anyone trying to keep up with the ever-evolving relationship between drug enforcement and drug trafficking."--Peter Andreas, author of Smuggler Nation: How Illicit Trade Made America In 1971, Richard Nixon declared a war on drugs. Despite foreign policy efforts and attempts to combat supply lines, the United States has been for decades, and remains today, the largest single consumer market for illicit drugs on the planet. This volume argues that the war on drugs has been ineffective at best and, at worst, has been highly detrimental to many countries. Leading experts in the fields of public health, political science, and national security analyze how U.S. policies have affected the internal dynamics of Mexico, Colombia, Bolivia, Peru, Brazil, Argentina, Central America, and the Caribbean islands. Together, they present a comprehensive overview of the major trends in drug trafficking and organized crime in the early twenty-first century. In addition, the editors and contributors identify emerging issues and propose several policy options to address them. This accessible and expansive volume provides a framework for understanding the limits and liabilities in the U.S.-championed war on drugs throughout the Americas.
Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.
The medical use of marijuana is surrounded by a cloud of social, political, and religious controversy, which obscures the facts that should be considered in the debate. This book summarizes what we know about marijuana from evidence-based medicineâ€"the harm it may do and the relief it may bring to patients. The book helps the reader understand not only what science has to say about medical marijuana but also the logic behind the scientific conclusions. Marijuana and Medicine addresses the science base and the therapeutic effects of marijuana use for medical conditions such as glaucoma and multiple sclerosis. It covers marijuana's mechanism of action, acute and chronic effects on health and behavior, potential adverse effects, efficacy of different delivery systems, analysis of the data about marijuana as a gateway drug, and the prospects for developing cannabinoid drugs. The book evaluates how well marijuana meets accepted standards for medicine and considers the conclusions of other blue-ribbon panels. Full of useful facts, this volume will be important to anyone interested in informed debate about the medical use of marijuana: advocates and opponents as well as policymakers, regulators, and health care providers.
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.
This book concludes that AmericaOs drug policy should be reoriented in several ways to be more effective.