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Recently, the Research Triangle Institute completed a 5-year study sponsored by the National Institute on Drug Abuse called The Washington, D.C., Metropolitan Area Drug Study (DC MADS). Drug Use in Metropolitan America describes, relates, and integrates findings from the DC MADS study. More than that, though, this book places the findings in the larger context of our national drug abuse problem. Therefore, while there is some reporting of findings, there is more emphasis on examining the policy, research, and program implications that flow from the studies. This book will be of interest to researchers, practitioners, and policymakers in a number of areas, as well as to academics in sociology courses dealing with drugs, deviance, social problems, and research methodology. It should also appeal to those in the psychology and medical/allied health fields.
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 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.
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.
Making Connections: Geography and Drug Addiction Geography involves making connections – connections in our world among people and places, cultures, human activities, and natural processes. It involves understa- ing the relationships and ‘connections’ between seemingly disparate or unrelated ideas and between what is and what might be. Geography also involves connecting with people. When I rst encountered an extraordinarily vibrant, intelligent, and socially engaged scientist at a private d- ner several years ago, I was immediately captivated by the intensity of her passion to understand how and why people become addicted to drugs, and what could be done to treat or prevent drug addiction. Fortunately, she was willing to think beyond the bounds of her own discipline in her search for answers. Our conversation that evening, which began with her research on fundamental biochemical processes of drug addiction in the human body, evolved inevitably to an exploration of the ways in which research on the geographical context of drug addiction might contribute to the better understanding of etiology of addiction, its diffusion, its interaction with geographically variable environmental, social, and economic factors, and the strategies for its treatment and prevention. This fascinating woman, I soon learned, was Nora Volkow, the Director of the National Institute on Drug Abuse as well as the granddaughter of Leon Trotsky.