Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic

Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 105
Release: 2019-08-01
Genre: Medical
ISBN: 0309492238

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The United States is facing an opioid use disorder epidemic with opioid overdoses killing 47,000 people in the U.S. in 2017. The past three decades have witnessed a significant increase in the prescribing of opioids for pain, based on the belief that patients were being undertreated for their pain, coupled with a widespread misunderstanding of the addictive properties of opioids. This increase in prescribing of opioids also saw a parallel increase in addiction and overdose. In an effort to address this ongoing epidemic of opioid misuse, policy and regulatory changes have been enacted that have served to limit the availability of prescription opioids for pain management. Overlooked amid the intense focus on efforts to end the opioid use disorder epidemic is the perspective of clinicians who are experiencing a significant amount of daily tension as opioid regulations and restrictions have limited their ability to treat the pain of their patients facing serious illness. Increased public and clinician scrutiny of opioid use has resulted in patients with serious illness facing stigma and other challenges when filling prescriptions for their pain medications or obtaining the prescription in the first place. Thus clinicians, patients, and their families are caught between the responses to the opioid use disorder epidemic and the need to manage pain related to serious illness. The National Academies of Sciences, Engineering, and Medicine sponsored a workshop on November 29, 2018, to examine these unintended consequences of the responses to the opioid use disorder epidemic for patients, families, communities, and clinicians, and to consider potential policy opportunities to address them. This publication summarizes the presentations and discussions from the workshop.

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.

Pain Management and the Opioid Epidemic

Pain Management and the Opioid Epidemic
Author: National Academies of Sciences, Engineering, and Medicine (U.S.). Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse
Publisher:
Total Pages: 393
Release: 2017
Genre: Chronic pain
ISBN: 9780309462686

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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.

Advancing Therapeutic Development for Pain and Opioid Use Disorders Through Public-Private Partnerships

Advancing Therapeutic Development for Pain and Opioid Use Disorders Through Public-Private Partnerships
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 107
Release: 2018-05-22
Genre: Medical
ISBN: 0309474027

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Chronic pain is one of the most prevalent, costly, and disabling health conditions in the United States. Estimates show that more than 11 percent of the American population suffer from chronic pain, yet the federal pain research investment has been minimal. In parallel with a gradual increased recognition of the problems of treating chronic pain, the opioid epidemic has emerged as a growing public health emergency. The intersection of these two crises lies in the fact that an unintended consequence of treating pain has been an increasing number of opioid prescriptions and diversion of drugs for illicit purposes. In May 2017, the National Institutes of Health (NIH), and the National Institute on Drug Abuse announced a publicâ€"private partnership to develop solutions to the opioid crisis and cut in half the time it takes to develop non-addictive analgesics. To advance the planning of NIH's anticipated publicâ€"private partnerships, the National Academies' Forum on Neuroscience and Nervous Systems Disorders hosted a public workshop that brought together a diverse group of stakeholders from academia, federal agencies, advocacy organizations and companies developing therapeutics for pain and opioid use disorders. Participants discussed potential strategies to accelerate development of non-addictive pain medications and treatments for opioid use disorders. This publication summarizes the presentations and discussions from the workshop.

The Opioid Epidemic and the Therapeutic Community Model

The Opioid Epidemic and the Therapeutic Community Model
Author: Jonathan D. Avery
Publisher: Springer Nature
Total Pages: 154
Release: 2019-10-18
Genre: Psychology
ISBN: 3030262731

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This book aims to explore the evidence supporting the therapeutic community (TC) modality as a uniquely effective approach to care of individuals living with opioid use disorder and other addictions, and also to identify salient mediators of improved outcome, including long-term treatment and removal from the opioid-associated environment. The book includes multiple international perspectives and is designed for worldwide appeal—for countries that have established some TCs with success, those looking to improve care, and those looking to build them for the first time. Written by experts in addiction psychiatry and medicine, this book describes the unique role of therapeutic communities in treating substance use disorders, how the model has changed over time and adapted to diverse sociocultural contexts and systems of care, and how the TC model may serve an important population in the context of the current opioid epidemic. The chapters are written so as to be accessible for clinicians across specialties and professions. The Opioid Epidemic and the Therapeutic Community Model is an excellent resource for all professionals interested in diverse and effective models of care to treat opioid use disorder and other addictions, including addiction medicine specialists, psychiatrists, psychologists, rehabilitation administrators, hospitalists, social workers, public health workers, students, and the interested public

Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic

Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 105
Release: 2019-07-01
Genre: Medical
ISBN: 0309492262

Download Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic Book in PDF, Epub and Kindle

The United States is facing an opioid use disorder epidemic with opioid overdoses killing 47,000 people in the U.S. in 2017. The past three decades have witnessed a significant increase in the prescribing of opioids for pain, based on the belief that patients were being undertreated for their pain, coupled with a widespread misunderstanding of the addictive properties of opioids. This increase in prescribing of opioids also saw a parallel increase in addiction and overdose. In an effort to address this ongoing epidemic of opioid misuse, policy and regulatory changes have been enacted that have served to limit the availability of prescription opioids for pain management. Overlooked amid the intense focus on efforts to end the opioid use disorder epidemic is the perspective of clinicians who are experiencing a significant amount of daily tension as opioid regulations and restrictions have limited their ability to treat the pain of their patients facing serious illness. Increased public and clinician scrutiny of opioid use has resulted in patients with serious illness facing stigma and other challenges when filling prescriptions for their pain medications or obtaining the prescription in the first place. Thus clinicians, patients, and their families are caught between the responses to the opioid use disorder epidemic and the need to manage pain related to serious illness. The National Academies of Sciences, Engineering, and Medicine sponsored a workshop on November 29, 2018, to examine these unintended consequences of the responses to the opioid use disorder epidemic for patients, families, communities, and clinicians, and to consider potential policy opportunities to address them. This publication summarizes the presentations and discussions from the workshop.

Acute Pain Management

Acute Pain Management
Author: Pamela E. Macintyre
Publisher: CRC Press
Total Pages: 262
Release: 2021-06-20
Genre: Medical
ISBN: 100037971X

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With a focus on practical acute pain management in adults in the hospital setting, this book provides health professionals with simple and practical information to help them manage patients with acute pain safely and effectively. • Combines evidence-based information with practical guidelines and protocols • Covers the pharmacology of opioids, local anesthetics, and nonopioid and adjuvant analgesic agents • Discusses management of acute pain in both surgical and nonsurgical acute pain settings including in patients with spinal cord or burns injuries and selected medical illnesses • Includes evidence-based information about management of acute pain in some specific patient groups , including the older patient, opioid-tolerant patients, and those with addiction disorders, pregnant or lactating patients and patients with obstructive sleep apnea or who have renal or hepatic impairment • Considers the role of acute pain management in the context of the current opioid epidemic and identifies possible strategies to minimise the risks. This resource will be helpful to a variety of professionals in assessing and managing acute pain.

Opioid Therapy in Infants, Children, and Adolescents

Opioid Therapy in Infants, Children, and Adolescents
Author: Ravi D. Shah
Publisher: Springer Nature
Total Pages: 355
Release: 2020-02-21
Genre: Medical
ISBN: 3030362876

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Opioid analgesics are among the most effective medications for pain management but are associated with serious and increasing public health problems, including abuse, addiction, and death from overdose. Currently, there is an opioid epidemic in the United States with the rate of prescription opioid-related overdose deaths quadrupling over the last 15 years. Pediatric patients are particularly vulnerable to the devastating consequences of opioid misuse. Adolescents who are prescribed opioids are at a higher risk for abusing illicit drugs later in life. Clinicians managing pediatric pain must account for such issues while still delivering effective analgesia to young patients who suffer from both acute and chronic pain. Opioid Therapy in Children and Adolescents is designed to explore the unique aspects of opioid therapy in pediatric patients. An introductory framework provides historical context and describes the epidemiology of the opioid crisis with focus on pediatric implications. Subsequent chapters focus on pediatric opioid pharmacology, safe opioid prescribing practices, and non-opioid alternatives to managing pediatric pain states, including multimodal analgesic strategies, interdisciplinary approaches, and complementary medicine. Mitigation strategies against pediatric opioid diversion and misuse are addressed to help clinicians develop practice changes that protect pediatric patients from opioid-related morbidity and mortality. Clinical case examples are also utilized throughout the text to provide grounding for each chapter and a context within which to examine pertinent issues. This first of its kind book provides a comprehensive approach that will guide clinicians to appropriately and safely prescribe opioid analgesics to pediatric patients suffering from pain. It is an invaluable resource for pediatricians, family practitioners, anesthesiologists, pediatric oncologists, and other clinicians who manage pediatric pain.

How We Hurt

How We Hurt
Author: Melina Sherman
Publisher: Oxford University Press
Total Pages: 201
Release: 2023-08-29
Genre: Education
ISBN: 0197698220

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How We Hurt dives into the institutional and cultural dimensions of the ongoing opioid epidemic. In a detailed analysis of pain management, opioid regulation, pharmaceutical branding, self-help, and public discourses on opioid addiction, Melina Sherman argues that the linchpin underlying the opioid epidemic's evolution in North America is the problem of pain. By unpacking the politics of pain in different domains, How We Hurt shows how the crisis emerged and shifted, and why it looks the way it does today. The book's chapters begin by tracing the trajectory of opioids in pain management, where decisions regarding the measurement of pain led to relief becoming wedded to opioids in medicine. The following chapters examine the problem of pain in opioid regulation, pharmaceutical branding, and the self-help industry. In these areas, a disastrous combination of strategic ignorance and deep-seated ties between public health entities and pharmaceutical companies drove the influx of opioids onto the market and into our medicine cabinets. The book's penultimate chapter applies the analysis of pain to the problem of opioid addiction in popular discourse and shows how the opioid crisis has evolved alongside new conceptions of addiction and people who use opioids that condition whose pain is seen as legitimate and whose is not. Finally, the book concludes by considering the implications of its findings for the development of drug policy and future research on public health disasters, insisting on an interdisciplinary and multi-faceted approach to the study of pain and its place American culture.