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Deaths involving synthetic opioids, such as fentanyl, increased from roughly 3,000 in 2013 to more than 30,000 in 2018. This book provides readers with insights intended to improve their understanding of the synthetic opioid problem.
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 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
The inside story of a band of entrepreneurial upstarts who made millions selling painkillers—until their scheme unraveled, putting them at the center of a landmark criminal trial. • SOON TO BE THE MAJOR MOTION PICTURE PAIN HUSTLERS STARRING EMILY BLUNT AND CHRIS EVANS "Unfolds with the velocity and verve of a Scorsese film…A tour de force."—Patrick Radden Keefe, New York Times bestselling author of Empire of Pain and Say Nothing John Kapoor had already amassed a small fortune in pharmaceuticals when he founded Insys Therapeutics. It was the early 2000s, a boom time for painkillers, and he developed a novel formulation of fentanyl, the most potent opioid on the market. Kapoor, a brilliant immigrant scientist with relentless business instincts, was eager to make the most of his innovation. He gathered around him an ambitious group of young lieutenants. His head of sales—an unstable and unmanageable leader, but a genius of persuasion—built a team willing to pull every lever to close a sale, going so far as to recruit an exotic dancer ready to scrape her way up. They zeroed in on the eccentric and suspect doctors receptive to their methods. Employees at headquarters did their part by deceiving insurance companies. The drug was a niche product, approved only for cancer patients in dire condition, but the company’s leadership pushed it more widely, and together they turned Insys into a Wall Street sensation. But several insiders reached their breaking point and blew the whistle. They sparked a sprawling investigation that would lead to a dramatic courtroom battle, breaking new ground in the government’s fight to hold the drug industry accountable in the spread of addictive opioids. In The Hard Sell, National Magazine Award–finalist Evan Hughes lays bare the pharma playbook. He draws on unprecedented access to insiders of the Insys saga, from top executives to foot soldiers, from the patients and staff of far-flung clinics to the Boston investigators who treated the case as a drug-trafficking conspiracy, flipping cooperators and closing in on the key players. With colorful characters and true suspense, The Hard Sell offers a bracing look not just at Insys, but at how opioids are sold at the point they first enter the national bloodstream—in the doctor’s office.
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.
Apple Best Books of 2021 Longlisted for the Andrew Carnegie Medal * Shortlisted for the Zocalo Book Prize From the New York Times bestselling author of Dreamland, a searing follow-up that explores the terrifying next stages of the opioid epidemic and the quiet yet ardent stories of community repair. Sam Quinones traveled from Mexico to main streets across the U.S. to create Dreamland, a groundbreaking portrait of the opioid epidemic that awakened the nation. As the nation struggled to put back the pieces, Quinones was among the first to see the dangers that lay ahead: synthetic drugs and a new generation of kingpins whose product could be made in Magic Bullet blenders. In fentanyl, traffickers landed a painkiller a hundred times more powerful than morphine. They laced it into cocaine, meth, and counterfeit pills to cause tens of thousands of deaths-at the same time as Mexican traffickers made methamphetamine cheaper and more potent than ever, creating, Sam argues, swaths of mental illness and a surge in homelessness across the United States. Quinones hit the road to investigate these new threats, discovering how addiction is exacerbated by consumer-product corporations. “In a time when drug traffickers act like corporations and corporations like traffickers,” he writes, “our best defense, perhaps our only defense, lies in bolstering community.” Amid a landscape of despair, Quinones found hope in those embracing the forgotten and ignored, illuminating the striking truth that we are only as strong as our most vulnerable. Weaving analysis of the drug trade into stories of humble communities, The Least of Us delivers an unexpected and awe-inspiring response to the call that shocked the nation in Sam Quinones's award-winning Dreamland.
Novel Psychoactive Substances: Classification, Pharmacology and Toxicology provides readers with background on the classification, detection, supply and availability of novel psychoactive substances, otherwise known as "legal highs." This book also covers individual classes of novel psychoactive substances that have recently emerged onto the recreational drug scene and provides an overview of the pharmacology of the substance followed by a discussion of the acute and chronic harm or toxicity associated with the substance. Written by international experts in the field, this multi-authored book is a valuable reference for scientists, clinicians, academics, and regulatory and law enforcement professionals. - Includes chapters written by international experts in the field. - Provides a comprehensive look at the classification, detection, availability and supply of novel psychoactive substances, in addition to the pharmacology and toxicology associated with the substance. - Offers a single source for all interested parties working in this area, including scientists, academics, clinicians, law enforcement and regulatory agencies. - Provides a full treatment of novel psychoactive substances that have recently emerged onto the recreational drug scene including mephedrone and the synthetic cannabinoid receptors in 'spice' / 'K2'.
A New York Times Bestseller A Wall Street Journal Bestseller A New York Times Notable Book of 2020 A New York Times Book Review Editors’ Choice Shortlisted for the Financial Times and McKinsey Business Book of the Year A New Statesman Book to Read From economist Anne Case and Nobel Prize winner Angus Deaton, a groundbreaking account of how the flaws in capitalism are fatal for America's working class Deaths of despair from suicide, drug overdose, and alcoholism are rising dramatically in the United States, claiming hundreds of thousands of American lives. Anne Case and Angus Deaton explain the overwhelming surge in these deaths and shed light on the social and economic forces that are making life harder for the working class. As the college educated become healthier and wealthier, adults without a degree are literally dying from pain and despair. Case and Deaton tie the crisis to the weakening position of labor, the growing power of corporations, and a rapacious health-care sector that redistributes working-class wages into the pockets of the wealthy. This critically important book paints a troubling portrait of the American dream in decline, and provides solutions that can rein in capitalism's excesses and make it work for everyone.
Emphasizes the disturbing consequences poaching and trafficking pose globally in terms of both biodiversity and public health
Offering timely guidance on the junction of the opioid crisis and infectious diseases, this practical handbook by Dr. Brianna L. Norton provides concise yet comprehensive coverage of a growing patient population. Infectious disease specialists are increasingly seeing patients who previously used opiods and now use intravenous drugs. Many challenges are unique to this patient population, including new and growing infections such as hepatitis C, endocarditis, HIV, and hepatitis B. The Opioid Epidemic and Infectious Diseases is an up-to-date, real-world guide that covers the scope of the problem, management guidelines, and much more. - Describes the new landscape of the opioid crisis in the U.S. and its intersection with infectious diseases, including epidemiology, Opioid Use Disorder (OUD) and rural America, and more. - Offers practical guidance on (OUD) and infectious co-morbidities like hepatitis C, STDs, endocarditis, HIV, and hepatitis B. - Covers prevention, treatment, and harm reduction. - Discusses OUD, infectious diseases, and the criminal justice system. - Consolidates today's available information and guidance into a single, convenient resource.