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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.


The Risks of Prescription Drugs

The Risks of Prescription Drugs
Author: Donald Light
Publisher: Columbia University Press
Total Pages: 179
Release: 2010
Genre: Business & Economics
ISBN: 0231146922

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Few people realize that prescription drugs have become a leading cause of death, disease, and disability. Adverse reactions to widely used drugs, such as psychotropics and birth control pills, as well as biologicals, result in FDA warnings against adverse reactions. The Risks of Prescription Drugs describes how most drugs approved by the FDA are under-tested for adverse drug reactions, yet offer few new benefits. Drugs cause more than 2.2 million hospitalizations and 110,000 hospital-based deaths a year. Serious drug reactions at home or in nursing homes would significantly raise the total. Women, older people, and people with disabilities are least used in clinical trials and most affected. Health policy experts Donald Light, Howard Brody, Peter Conrad, Allan Horwitz, and Cheryl Stults describe how current regulations reward drug companies to expand clinical risks and create new diseases so millions of patients are exposed to unnecessary risks, especially women and the elderly. They reward developing marginally better drugs rather than discovering breakthrough, life-saving drugs. The Risks of Prescription Drugs tackles critical questions about the pharmaceutical industry and the privatization of risk. To what extent does the FDA protect the public from serious side effects and disasters? What is the effect of giving the private sector and markets a greater role and reducing public oversight? This volume considers whether current rules and incentives put patients' health at greater risk, the effect of the expansion of disease categories, the industry's justification of high U.S. prices, and the underlying shifts in the burden of risk borne by individuals in the world of pharmaceuticals. Chapters cover risks of statins for high cholesterol, SSRI drugs for depression and anxiety, and hormone replacement therapy for menopause. A final chapter outlines six changes to make drugs safer and more effective. Suitable for courses on health and aging, gender, disability, and minority studies, this book identifies the Risk Proliferation Syndrome that maximizes the number of people exposed to these risks. Additional Columbia / SSRC books on the privatization of risk and its implications for Americans: Bailouts: Public Money, Private ProfitEdited by Robert E. Wright Disaster and the Politics of InterventionEdited by Andrew Lakoff Health at Risk: America's Ailing Health System-and How to Heal ItEdited by Jacob S. Hacker Laid Off, Laid Low: Political and Economic Consequences of Employment InsecurityEdited by Katherine S. Newman Pensions, Social Security, and the Privatization of RiskEdited by Mitchell A. Orenstein


Bad Pharma

Bad Pharma
Author: Ben Goldacre
Publisher: Macmillan
Total Pages: 479
Release: 2014-04
Genre: Business & Economics
ISBN: 0865478066

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Originally published in 2012, revised edition published in 2013, by Fourth Estate, Great Britain; Published in the United States in 2012, revised edition also, by Faber and Faber, Inc.


To Err Is Human

To Err Is Human
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 312
Release: 2000-03-01
Genre: Medical
ISBN: 0309068371

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Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine


Medicines That Kill

Medicines That Kill
Author: James L. Marcum
Publisher: Tyndale House Publishers, Inc.
Total Pages: 258
Release: 2013-01-17
Genre: Religion
ISBN: 1414382804

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The recent deaths of celebrities like Michael Jackson, Anna Nicole Smith, Heath Ledger, and Whitney Houston have shown a spotlight on the overuse and abuse of prescription drugs. Most people believe that prescription drugs are safer than illegal substances. But, when combined with other over-the-counter sedatives, prescription drugs can be every bit as powerful, addictive, and dangerous. In 2006, overdoses on a class of prescription pain relievers called opioid analgesics killed more people than those killed by overdoses on cocaine and heroin combined. Right now, among 35 to 54 year olds, poisoning by prescription drugs is the most common cause of accidental death—even more so than auto-related deaths. In Medicines That Kill, Dr. Marcum shines a light on the addictive power of prescription medication and how you can protect yourself and your family by practicing healthy habits.


Patient Safety

Patient Safety
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 551
Release: 2003-12-20
Genre: Medical
ISBN: 0309090776

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Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.


Are Your Prescriptions Killing You?

Are Your Prescriptions Killing You?
Author: Armon B. Neel (Jr.)
Publisher: Simon and Schuster
Total Pages: 297
Release: 2012-07-03
Genre: Family & Relationships
ISBN: 145160839X

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A veteran board-certified pharmacist cites the high number of annual deaths associated with prescription drug side effects, calling for changes in prescription practices that account for the needs of aging bodies.


Prescription for Injury

Prescription for Injury
Author: Colin Downes-Grainger
Publisher: Fastprint Publishing
Total Pages: 225
Release: 2010-05-14
Genre: Benzodiazepine abuse
ISBN: 9781844268030

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Routine denial and the downplaying of harm should have no place in medicine but it is an institutional attitude and policy in the UK. The Department of Health and the MHRA play politics with people's lives. There is no doubt that the defence and underesti


How We Do Harm

How We Do Harm
Author: Otis Webb Brawley, MD
Publisher: St. Martin's Press
Total Pages: 320
Release: 2012-01-31
Genre: Biography & Autobiography
ISBN: 1429941502

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How We Do Harm exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians' provide, insurance companies that don't demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm. Dr. Otis Brawley is the chief medical and scientific officer of The American Cancer Society, an oncologist with a dazzling clinical, research, and policy career. How We Do Harm pulls back the curtain on how medicine is really practiced in America. Brawley tells of doctors who select treatment based on payment they will receive, rather than on demonstrated scientific results; hospitals and pharmaceutical companies that seek out patients to treat even if they are not actually ill (but as long as their insurance will pay); a public primed to swallow the latest pill, no matter the cost; and rising healthcare costs for unnecessary—and often unproven—treatments that we all pay for. Brawley calls for rational healthcare, healthcare drawn from results-based, scientifically justifiable treatments, and not just the peddling of hot new drugs. Brawley's personal history – from a childhood in the gang-ridden streets of black Detroit, to the green hallways of Grady Memorial Hospital, the largest public hospital in the U.S., to the boardrooms of The American Cancer Society—results in a passionate view of medicine and the politics of illness in America - and a deep understanding of healthcare today. How We Do Harm is his well-reasoned manifesto for change.


Case Studies in Pharmacy Ethics

Case Studies in Pharmacy Ethics
Author: Robert Veatch
Publisher: Oxford University Press
Total Pages: 332
Release: 2010-04-10
Genre: Medical
ISBN: 0199718997

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Pharmacists face ethical choices constantly -- sometimes dramatic life-and-death decisions, but more often subtle, less conspicuous choices that are nonetheless important. Among the topics confronted are assisted suicide, conscientious refusal, pain management, equitable distribution of drug resources within institutions and managed care plans, confidentiality, and alternative and non-traditional therapies. Veatch and Haddad's book, first published in 1999, was the first collection of case studies based on the real experiences of practicing pharmacists, for use as a teaching tool for pharmacy students. The second edition accounts for the many changes in pharmacy since 1999, including assisted suicide in Oregon, the purchasing of less expensive drugs from Canada, and the influence of managed care on prescriptions. The presentation of some cases is shortened, most are revised and updated, and two new chapters have been added. The first new chapter presents a new model for analyzing cases, while the second focuses on the ethics of new drug distribution systems, for example hospitals where pharmacists are forced to choose drugs based on cost-effectiveness, and internet based pharmacies.