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Pain medication plays an important role in the treatment of acute and chronic pain conditions, but some drugs, opioids in particular, have been overprescribed or prescribed without adequate safeguards, leading to an alarming rise in medication-related overdose deaths. The NIH Helping to End Addiction Long-term (HEAL) Initiative is a trans-agency effort to provide scientific solutions to stem the opioid crisis. One component of the initiative is to support biomarker discovery and rigorous validation in collaboration with industry leaders to accelerate high-quality clinical research into neurotherapeutics and pain. The use of objective biomarkers and clinical trial end points throughout the drug discovery and development process is crucial to help define pathophysiological subsets of pain, evaluate target engagement of new drugs and predict the analgesic efficacy of new drugs. In 2018, the NIH-led Discovery and Validation of Biomarkers to Develop Non-Addictive Therapeutics for Pain workshop convened scientific leaders from academia, industry, government and patient advocacy groups to discuss progress, challenges, gaps and ideas to facilitate the development of biomarkers and end points for pain. The outcomes of this workshop are outlined in this Consensus Statement.In 2018, the Discovery and Validation of Biomarkers to Develop Non-Addictive Therapeutics for Pain workshop convened to discuss strategies to facilitate the development of biomarkers and end points for pain. The outcomes of this workshop are outlined in this Consensus Statement.

Policy Points This article reconceptualizes our understanding of the opioid epidemic and proposes six strategies that address the epidemic's social roots. In order to successfully reduce drug‐related mortality over the long term, policymakers and public health leaders should develop partnerships with people who use drugs, incorporate harm reduction interventions, and reverse decades of drug criminalization policies. Context Drug overdose is the leading cause of injury‐related death in the United States. Synthetic opioids, predominantly illicit fentanyl and its analogs, surpassed prescription opioids and heroin in associated mortality rates in 2016. Unfortunately, interventions fail to fully address the current wave of the opioid epidemic and often omit the voices of people with lived experiences regarding drug use. Every overdose death is a culmination of a long series of policy failures and lost opportunities for harm reduction. Methods In this article, we conducted a scoping review of the opioid literature to propose a novel framework designed to foreground social determinants more directly into our understanding of this national emergency. The “continuum of overdose risk” framework is our synthesis of the global evidence base and is grounded in contemporary theories, models, and policies that have been successfully applied both domestically and internationally. Findings De‐escalating overdose risk in the long term will require scaling up innovative and comprehensive solutions that have been designed through partnerships with people who use drugs and are rooted in harm reduction. Conclusions Without recognizing the full drug‐use continuum and the role of social determinants, the current responses to drug overdose will continue to aggravate the problem they are trying to solve.

A new strategy for developing analgesic drugs is needed to avoid a replay of the fiasco that led to life-shattering addictions. A new strategy for developing analgesic drugs is needed to avoid a replay of the fiasco that led to life-shattering addictions. Clifford Woolf stands in a laboratory

Opioid addiction has become a global epidemic and a national health crisis in recent years, with the number of opioid overdose fatalities steadily increasing since the 1990s. In contrast to the dynamics of a typical illicit drug or disease epidemic, opioid addiction has its roots in legal, prescription medication—a fact which greatly increases the exposed population and provides additional drug accessibility for addicts. In this paper, we present a mathematical model for prescription drug addiction and treatment with parameters and validation based on data from the opioid epidemic. Key dynamics considered include addiction through prescription, addiction from illicit sources, and treatment. Through mathematical analysis, we show that no addiction-free equilibrium can exist without stringent control over how opioids are administered and prescribed, in which case we estimate that the epidemic would cease to be self-sustaining. Numerical sensitivity analysis suggests that relatively low states of endemic addiction can be obtained by primarily focusing on medical prevention followed by aggressive treatment of remaining cases—even when the probability of relapse from treatment remains high. Further empirical study focused on understanding the rate of illicit drug dependence versus overdose risk, along with the current and changing rates of opioid prescription and treatment, would shed significant light on optimal control efforts and feasible outcomes for this epidemic and drug epidemics in general.

Unfortunately, enthusiasm over such interventions may eventually dwindle due to time requirements and/or prohibitive cost. [...]there is a need for a simple, cost-effective method to have a meaningful and lasting impact on opioid overprescription. [...]the use of email makes the intervention simple, widely available, and cost effective. Additionally, as recognized by the authors, the study used prescription patterns as a surrogate for opioid addition and abuse. [...]the study does not analyze at the result level, which would be to directly measure the decrease in opioid misuse, abuse and addiction among patients undergoing dialysis access procedures.

Factors worsening the opioid epidemic during the coronavirus disease 2019 (COVID-19) pandemic provide valuable insight for strategy change where we have historically suffered great loss, bodily and financially.

For the past two decades, the USA has been embroiled in a growing prescription drug epidemic. The ripples of this epidemic have been especially apparent in the state of Maine, which has fought hard to mitigate the damage caused by addiction to pharmaceutical and illicit opioids. In this study, we construct a mathematical model of the opioid epidemic incorporating novel features important to better understanding opioid abuse dynamics. These features include demographic differences in population susceptibility, general transmission expressions, and combined consideration of pharmaceutical opioid and heroin abuse. We demonstrate the usefulness of this model by calibrating it with data for the state of Maine. Model calibration is accompanied by sensitivity and uncertainty analysis to quantify potential error in parameter estimates and forecasts. The model is analyzed to determine the mechanisms most influential to the number of opioid abusers and to find effective ways of controlling opioid abuse prevalence. We found that the mechanisms most influential to the overall number of abusers in Maine are those involved in illicit pharmaceutical opioid abuse transmission. Consequently, preventative strategies that controlled for illicit transmission were more effective over alternative approaches, such as treatment. These results are presented with the hope of helping to inform public policy as to the most effective means of intervention.

[...]laparoscopic appendectomy patients leave within 24–72 hours. [...]pre-discharge analgesic drug costs were calculated using the Wholesale Acquisition Cost (WAC) or the manufacture drug price. Most hospitals benefit from dramatic discounts and rebates afforded by pharmaceutical companies. Because cost of LB remains a barrier to uptake, accurately quantifying hospital costs is a pivotal area for future study.9,10 This study emphasizes the benefits of LB and the short-term costs.

The United States is experiencing an opioid overdose epidemic. Point-of-care (POC) drug of abuse testing is a useful tool to combat the intensified opioid epidemic. To review commercially available POC drug of abuse testing involving opioids, to review opportunities and challenges for POC opioid testing and emerging testing methods in research literature, and finally to summarize unmet clinical needs and future development prospects. The Google search engine was used to access information for commercial opioid POC devices and the Google Scholar search engine was used to access research literature published from 2000 to 2019 for opioid POC tests. The opioid epidemic provides unprecedented opportunities for POC drug testing, with significant clinical needs. Compared with gold standard tests, limitations for commercially available opioid POC testing include lower analytical sensitivity, lower specificity, and cross-reactivity. In response to unmet clinical needs, novel methods have emerged in research literature, such as microfluidics and miniature mass spectrometry. Future prospects include the development of quantitative POC devices and smarter and real-time drug testing.

A compound has been discovered that increases the potency and duration of action of naloxone, a drug used to reverse the effects of opioid overdoses — possibly opening up another way to save lives. A compound that boosts the effects of a therapy for opioid overdoses.