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Millions of Americans are taking prescription drugs made in China and don't know it-- and pharmaceutical companies are not eager to tell them. This probing book examines the implications for the quality and availability of vital medicines for consumers. Several decades ago, penicillin, vitamin C, and many other prescription and over-the-counter products were manufactured in the United States. But with the rise of globalization, antibiotics, antidepressants, birth control pills, blood pressure medicines, cancer drugs, among many others are made in China and sold in the United States. China's biggest impact on the US drug supply is making essential ingredients for thousands of medicines found in American homes and used in hospital intensive care units and operating rooms. The authors convincingly argue that there are at least two major problems with this scenario. First, it is inherently risky for the United States to become dependent on any one country as a source for vital medicines, especially given the uncertainties of geopolitics. For example, if an altercation in the South China Sea causes military personnel to be wounded, doctors may rely upon medicines with essential ingredients made by the adversary. Second, lapses in safety standards and quality control in Chinese manufacturing are a risk. Citing the concerns of FDA officials and insiders within the pharmaceutical industry, the authors document incidents of illness and death caused by contaminated medications that prompted reform. This is a disturbing, well-researched book and a wake-up call for improving the current system of drug supply and manufacturing.
Examines the possible consequences of the growth of prescription drug use and the impact of direct-to-consumer promotion (DTC) and off-label marketing.
With Americans paying more than $200 billion each year for prescription pills, the pharmaceutical business is the most profitable in the nation. The popularity of prescription drugs in recent decades has remade the doctor/patient relationship, instituting prescription-writing and pill-taking as an integral part of medical practice and everyday life. Medicating Modern America examines the meanings behind this pharmaceutical revolution through the interconnected histories of eight of the most influential and important drugs: antibiotics, mood stabilizers, hormone replacement therapy, oral contraceptives, tranquilizers, stimulants, statins, and Viagra. All of these drugs have been popular, profitable, influential, and controversial, and the authors take a historical approach to studying their development, prescription, and consumption. This perspective locates the histories of prescription medicines in specific cultural contexts while revealing the extent to which contemporary debates about pharmaceutical drugs echo concerns voiced by Americans in the past. Exploring the rich and multi-faceted history of pharmaceutical drugs in the United States, Medicating Modern America unveils the untold stories behind America's pharmaceutical obsession. Contributors include: Robert Bud, Jennifer R. Fishman, Jeremy A. Greene, David Healy, Suzanne White Junod, Ilina Singh, Andrea Tone, and Elizabeth Siegel Watkins.
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 flagship title of the certification suite from the American College of Sports Medicine, ACSM's Guidelines for Exercise Testing and Prescription is a handbook that delivers scientifically based standards on exercise testing and prescription to the certification candidate, the professional, and the student. The 9th edition focuses on evidence-based recommendations that reflect the latest research and clinical information. This manual is an essential resource for any health/fitness and clinical exercise professional, physician, nurse, physician assistant, physical and occupational therapist, dietician, and health care administrator. This manual give succinct summaries of recommended procedures for exercise testing and exercise prescription in healthy and diseased patients.
The Nature Rx movement is changing campus life. Offering alternative ways to deal with the stress that students are under, these programs are redefining how to provide students with the best possible environment in which to be healthy, productive members of the academic community. In Nature Rx, Donald A. Rakow and Gregory T. Eells summarize the value of nature prescription programs designed to encourage college students to spend time in nature and to develop a greater appreciation for the natural world. Because these programs are relatively new, there are many lessons for practitioners to learn; but clinical studies demonstrate that students who regularly spend time in nature have reduced stress and anxiety levels and improved mood and outlook. In addition to the latest research, the authors present a step-by-step formula for constructing, sustaining, and evaluating Nature Rx programs, and they profile four such programs at American colleges. The practical guidance in Nature Rx alongside the authors' vigorous argument for the benefits of these programs for both students and institutions places Rakow and Eells at the forefront of this burgeoning movement.
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
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.
Discusses the arguments for and against the use of marijuana as a medical treatment.