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American epidemic : reporting from the front lines of the opioid crisis
\"Just a few years ago, the opioid crisis could be referred to as a \"silent epidemic,\" but it is no longer possible to argue that the scourge of opiate addiction is overlooked. This is in large part thanks to the writings featured in this volume, which includes some of the most impactful reporting in the United States in recent years addressing the opiate addiction crisis. American Epidemic collects, for the first time, the key works of reportage and analysis that provide the best picture available of the origins, consequences, and human calamity associated with the epidemic.\"--Provided by publisher.
Book
Medications for Opioid Use Disorder Save Lives
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 exist-like evidence-based medications-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.
eBook
The opioid crisis
\"Opioids are pain relievers that include legal drugs like morphine, fentanyl, and oxycodone and illegal drugs like heroin. In 2017, the US Department of Health and Human Services declared the opioid epidemic a public health crisis after 42,249 people in the United States died of opioid overdoses in 2016. Opioid prescription has been on the rise since the 1990s, when pharmaceutical companies asserted that the pain relievers were not addictive, though the tragic consequences have proven otherwise. This volume explores the history of the opioid crisis and solutions that have been proposed to fight this increasingly deadly epidemic.\"-- Provided by publisher.
Book
Opioid therapy in the 21st century
Opioid Therapy in the 21st Century, Second Edition provides clinicians with up-to-date, evidence-based information about appropriate opioid use, including the potential benefits and adverse affects of the therapy.
eBook
Progress of Four Programs from the Comprehensive Addiction and Recovery Act
Substance use disorder (SUD) and opioid use disorder are significant public health threats that affect millions of Americans each year.To help address overdose deaths and lack of access to treatment, the Comprehensive Addiction and Recovery Act (CARA) was signed into law on July 22, 2016.
eBook
Getting wrecked : women, incarceration, and the American opioid crisis
\"Getting Wrecked provides a rich ethnographic account of women battling addiction as they cycle through jail, prison, and community treatment programs in Massachusetts. Since incarceration has become a predominant American social policy for managing the problem of drug use, including the opioid epidemic, this book examines how prisons and jails have attempted concurrent programs of punishment and treatment to deal with inmates struggling with a diagnosis of substance use disorder. An addiction physician and a medical anthropologist, Kimberly Sue powerfully illustrates the impacts of incarceration on women's lives as they seek well-being and better health while confronting lives marked by structural violence, gender inequity, and ongoing trauma\"--Provided by publisher.
Book
Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect
Objective. Opioids are frequently prescribed for chronic low back pain (CLBP), but there are broad individual differences in the benefits and risks of opioid therapy, including the development opioid-induced hyperalgesia. This study examined quantitative sensory testing (QST) data among a group of CLBP patients undergoing sustained oral opioid treatment. We investigated whether individual differences in psychological characteristics were related to opioid-induced changes in pain perception and pain modulation.
Design. The six-month, open-label trial evaluated patients with low to high levels of negative affect (e.g., symptoms of distress, depression and anxiety); participants underwent QST at baseline (prior to initiating treatment) and during oral opioid treatment.
Setting. A chronic pain management center.
Patients. The 31 study participants had chronic discogenic back pain, with a pain intensity rating >3/10. Participants were divided into groups with high vs. low levels of Negative Affect (NA).
Results. In the previously-published manuscript describing the clinical outcomes of the trial, high NA patients achieved only about half of the analgesic effect observed in the low NA group (Wasan AD, Michna E, Edwards RR, et al. Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain. Anesthesiology 2015;123:861–72). The QST findings reported here suggested that tolerance to experimental (cold pressor) pain and conditioned pain modulation tended to decrease in the high NA group over the course of opioid treatment, while temporal summation of mechanical pain declined in the low NA group.
Conclusions. These results reveal that while the low NA group seemed to exhibit a generally adaptive, analgesic pattern of changes during opioid management, the high NA group showed a pattern more consistent with opioid-induced hyperalgesic processes. A greater susceptibility to hyperalgesia-promoting changes in pain modulation among patients with high levels of distress may contribute to a lower degree of benefit from opioid treatment in high NA patients.
Journal Article
