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Pain Management and the Opioid Epidemic

Pain Management and the Opioid Epidemic
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 483
Release: 2017-09-28
Genre: Medical
ISBN: 0309459575

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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.


Medications for Opioid Use Disorder Save Lives

Medications for Opioid Use Disorder Save Lives
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 175
Release: 2019-06-16
Genre: Medical
ISBN: 0309486483

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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.


American Overdose

American Overdose
Author: Chris McGreal
Publisher: PublicAffairs
Total Pages: 381
Release: 2018-11-13
Genre: Social Science
ISBN: 1541773772

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A comprehensive portrait of a uniquely American epidemic -- devastating in its findings and damning in its conclusions The opioid epidemic has been described as "one of the greatest mistakes of modern medicine." But calling it a mistake is a generous rewriting of the history of greed, corruption, and indifference that pushed the US into consuming more than 80 percent of the world's opioid painkillers. Journeying through lives and communities wrecked by the epidemic, Chris McGreal reveals not only how Big Pharma hooked Americans on powerfully addictive drugs, but the corrupting of medicine and public institutions that let the opioid makers get away with it. The starting point for McGreal's deeply reported investigation is the miners promised that opioid painkillers would restore their wrecked bodies, but who became targets of "drug dealers in white coats." A few heroic physicians warned of impending disaster. But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers -- resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.


Opioids in Medicine

Opioids in Medicine
Author: Enno Freye
Publisher: Springer Science & Business Media
Total Pages: 484
Release: 2008-03-12
Genre: Medical
ISBN: 1402059477

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This book fills the void to provide a comprehensive review of the theoretical knowledge and scope of opioid pharmacotherapy in pain medicine. While the information provided is obtainable in other major texts already in print, the present format style plus the illustrations will make easy reading and fast accessibility of information on opioids available. Information provided is based on clinical practice rather than pure experimental for use in daily practice.


Opioids and Their Receptors

Opioids and Their Receptors
Author: Mariana Spetea
Publisher: MDPI
Total Pages: 358
Release: 2020-12-18
Genre: Medical
ISBN: 3036500464

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The interest in opioids such as morphine, the prototypical opioid ligand, has been maintained through the years. The identification of endogenous opioids and their receptors (mu, delta, kappa, and nociceptin), molecular cloning, and the elucidation of the crystal structures of opioid receptors represent key milestones in opioid research. The opioid system modulates numerous pharmacological responses, with therapeutic (i.e., analgesia) and detrimental side effects (i.e., addiction). The medical use and misuse of opioids have dramatically increased, leading to the 21st century opioid crisis. This book presents recent developments in opioid drug discovery, specifically in the medicinal chemistry and pharmacology of new ligands targeting the opioid receptors as effective and safe therapeutics for human diseases. Furthermore, it draws a special attention to advancing concepts and strategies in opioid drug discovery to mitigate opioid liabilities. The diversity among the discussed topics is a testimony to the complexity of the opioid system, which results from the expression, regulation, and functional role of ligands and receptors. The array of multidisciplinary research areas illustrates the rapidly developing basic research and translational activities in opioid drug discovery. This book will serve as a useful reference while also stimulating continued research in the chemistry and pharmacology of opioids and their receptors, with the prospect of developing improved therapies for human diseases, but also improving health and quality of life in general.


In Pain

In Pain
Author: Travis Rieder
Publisher: HarperCollins
Total Pages: 320
Release: 2019-06-18
Genre: Social Science
ISBN: 0062854666

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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.


Chemistry of Opioids

Chemistry of Opioids
Author: Hiroshi Nagase
Publisher: Springer
Total Pages: 321
Release: 2011-01-21
Genre: Science
ISBN: 3642181074

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Recent Advances in the Synthesis of Morphine and Related Alkaloids; by N. Chida * Opioids in Preclinical and Clinical Trials; by H. Nagase and H. Fujii * Synthesis of 14-Alkoxymorphinan Derivatives and Their Pharmacological Actions; by H. Schmidhammer and M. Spetea * 14-Amino-4,5-Epoxymorphinan Derivatives and Their Pharmacological Actions; by J. W. Lewis and S. M. Husbands * Nonpeptidic Delta (δ) Opioid Agonists and Antagonists of the Diarylmethylpiperazine Class: What Have We Learned?; by S. N. Calderon * Synthesis of Neoclerodane Diterpenes and Their Pharmacological Effects; by K. M. Lovell, K. M. Prevatt-Smith, A. Lozama and T. E. Prisinzano * Synthesis of Novel Basic Skeletons Derived from Naltrexone; by H. Nagase and H. Fujii * Twin and Triplet Drugs in Opioid Research; by H. Fujii * 3D-Pharmacophore Identification for κ-Opioid Agonists Using Ligand-Based Drug-Design Techniques; by N. Yamaotsu and S. Hirono


Fighting the Opioid Epidemic

Fighting the Opioid Epidemic
Author: Amitava Dasgupta
Publisher: Elsevier
Total Pages: 160
Release: 2020-07-22
Genre: Medical
ISBN: 0128223901

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Fighting the Opioid Epidemic: The Role of Providers and the Clinical Laboratory in Understanding Who Is Vulnerable covers the important aspects that are essential in fighting the opioid epidemic. This succinct reference highlights how the toxicology laboratory can play a vital role in fighting the opioid epidemic by implementing a robust system for drugs of abuse testing as well as drug testing in pain management patients. It targets health care professionals in a technical manner, discussing polymorphisms of important genes that may be associated with increased vulnerability of alcohol and drug addiction to an individual. Covers all important aspects of opioid abuse, including genetic and environmental factors Discusses pharmacology, toxicology and the pharmacogenomics related to opioid metabolism Presents genetic and environmental factors associated with those vulnerable to opioid addiction, as well as the pitfalls of drug testing in pain management


Demystifying Opioid Conversion Calculations: A Guide for Effective Dosin

Demystifying Opioid Conversion Calculations: A Guide for Effective Dosin
Author: Mary Lynn McPherson
Publisher: ASHP
Total Pages: 263
Release: 2018-08-28
Genre: Medical
ISBN: 1585284300

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Praised by practitioners, students and instructors for its engaging approach to teaching a very complex subject, Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing, has long been the go-to guide for learning how to calculate opioid conversions. Now in its second edition, this reference is a must-have for clinicians involved in pain management at all levels. Written by pain management expert Mary Lynn McPherson, PharmD, MA, MDE, BCPS, CPE, Demystifying Opioid Conversion Calculations focuses on the calculations that practitioners use in actual practice, providing realistic scenarios for decision making. The revised edition covers the entire spectrum of opioid analgesics used to manage patients with moderate-to-severe pain and serious life­-limiting illnesses.


Cancer Pain Management

Cancer Pain Management
Author: Deborah B. McGuire
Publisher: Jones & Bartlett Learning
Total Pages: 404
Release: 1995
Genre: Analgesia
ISBN: 9780867207255

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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.