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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.
Tens of millions of people around the world live with chronic pain - many in such severe pain they are disabled by it. The Institute of Medicine estimates that chronic pain costs the U.S. alone $560 to $635 billion a year in direct medical costs and lost productivity. Morphine, an effective painkiller, costs only three cents a dose, yet because of excessive regulation in many countries, it is unavailable to millions of people who need it, even at the end of life. The World Health Organization notes that in addition to the one million end-stage AIDS/HIV patients who can't get morphine and other controlled medications, 5.5 million terminal cancer patients, nearly a million people suffering from accidents or violence, and an incalculable number of people living with chronic illnesses or recovering from surgery don't have access to it, either. Furthermore, women, children, older people, and the poor are disproportionally affected by inadequate pain relief. Physicians know almost nothing about chronic pain, much less how to treat it, for two reasons: medical schools barely teach it and government institutions allot almost nothing to the pain research budget. In The Global Pain Crisis: What Everyone Needs to Know®, renowned health journalist Judy Foreman addresses the most important questions about chronic pain: what is it, whom does it affect most, which pain relief methods in Western and alternative medicine are effective, what are the risks and benefits for opioids and marijuana, and how can the chronic pain crisis be resolved for good? Foreman's book is a wake-up call for a health problem that affects people across the globe, from all walks of life. Written in the classic, easy-to-read and quick reference style of the What Everyone Needs to Know® series, The Global Pain Crisis is a must-read for anyone whose life or work is affected by chronic pain.
Sickle Cell Pain is a panoramic, in-depth exploration of every scientific, human, and social dimension of this cruel disease. This comprehensive, definitive work is unique in that it is the only book devoted to sickle cell pain, as opposed to general aspects of the disease. The 752-page book links sickle cell pain to basic, clinical, and translational research, addressing various aspects of sickle pain from molecular biology to the psychosocial aspects of the disease. Supplemented with patient narratives, case studies, and visual art, Sickle Cell Pain’s scientific rigor extends through its discussion of analgesic pharmacology, including abuse-deterrent formulations. The book also addresses in great detail inequities in access to care, stereotyping and stigmatization of patients, the implications of rapidly evolving models of care, and recent legislation and litigation and their consequences.
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
From neurobiology to public policy, examines the chronic pain crisis, which is a major national health concern, discussing the latest scientific discoveries and advances in treatments and providing a sensible plan of action.
Cancer Pain Management, Second Edition will substantially advance pain education. The unique combination of authors -- an educator, a leading practitioner and administrator, and a research scientist -- provides comprehensive, authoritative coverage in addressing this important aspect of cancer care. The contributors, acknowledged experts in their areas, address a wide scope of issues. Educating health care providers to better assess and manage pain and improve patientsrsquo; and familiesrsquo; coping strategies are primary goals of this book. Developing research-based clinical guidelines and increasing funding for research is also covered. Ethical issues surrounding pain management and health policy implications are also explored.
NPR Best Book of 2019 A bioethicist’s eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic. Travis Rieder’s terrifying journey down the rabbit hole of opioid dependence began with a motorcycle accident in 2015. Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself. Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system. In Pain is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.
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.
Tens of millions of people around the world live with chronic pain - many in such severe pain they are disabled by it. The Institute of Medicine estimates that chronic pain costs the U.S. alone $560 to $635 billion a year in direct medical costs and lost productivity. Morphine, an effective painkiller, costs only three cents a dose, yet because of excessive regulation in many countries, it is unavailable to millions of people who need it, even at the end of life. The World Health Organization notes that in addition to the one million end-stage AIDS/HIV patients who can't get morphine and other controlled medications, 5.5 million terminal cancer patients, nearly a million people suffering from accidents or violence, and an incalculable number of people living with chronic illnesses or recovering from surgery don't have access to it, either. Furthermore, women, children, older people, and the poor are disproportionally affected by inadequate pain relief. Physicians know almost nothing about chronic pain, much less how to treat it, for two reasons: medical schools barely teach it and government institutions allot almost nothing to the pain research budget. In The Global Pain Crisis: What Everyone Needs to Know(R), renowned health journalist Judy Foreman addresses the most important questions about chronic pain: what is it, whom does it affect most, which pain relief methods in Western and alternative medicine are effective, what are the risks and benefits for opioids and marijuana, and how can the chronic pain crisis be resolved for good? Foreman's book is a wake-up call for a health problem that affects people across the globe, from all walks of life. Written in the classic, easy-to-read and quick reference style of the What Everyone Needs to Know(R) series, The Global Pain Crisis is a must-read for anyone whose life or work is affected by chronic pain.
Examines OxyContin, the so-called miracle prescription drug that swept the nation but led to overdoes and addiction, providing a look at the multi-billion-dollar pain managment business, its excesses and its abuses.