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.

This issue of Medical Clinics of North America, Guest Edited by Charles Argoff, MD is devoted to Chronic Pain Management. Dr. Argoff has assembled a group of expert authors to review the following topics: Chronic Pain Management: An Overview of Taxonomy, Conditions Commonly Encountered, and Assessment; The Acute to Chronic Pain Transition: Can Chronic Pain Be Prevented?; What Do We Know About the Pathophysiology of Chronic Pain? Implications for Treatment Considerations; An Overview of Pharmacologic Management of Chronic Pain; An Overview of Nonmedical Treatment of Chronic Pain; Managing Chronic Headache Disorders; Managing Osteoarthritis and Other Chronic Musculoskeletal Pain Disorders; Managing Neuropathic Pain; Managing Low Back and Other Spinal Pain Disorders; Exploring the Use of Chronic Opioid Therapy for Chronic Pain: When, How and for Whom?; The Role of Invasive Pain Management Modalities in the Treatment of Chronic Pain; Multimodal Management of Chronic Pain: What is the Evidence?; Managing Chronic Pain in Special Populations; and The Future of Pain Management as a Subspecialty: Meeting the Needs of the Patients We Care For.

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.

This issue of Medical Clinics of North America, Guest Edited by Deborah Wolbrette, MD is devoted to Cardiovascular Disease. Dr. Wolbrette has assembled a group of expert authors to review the following topics: Syncope due to Autonomic Dysfunction: Diagnosis and Management; 2013 Lipid Guidelines; 2014 Guideline for the Management of High Blood Pressure (JNC8); How to Follow Patients with Aortic and Mitral Valve Disease; The New Anticoagulants; Management of Atrial Fibrillation; Indications for Pacemakers, Implantable Defibrillators and Resynchronization Therapy; Current Status of Transcatheter Aortic Valve Replacement (TAVR); Chest Pain Evaluation: When to Order Troponin and Stress Tests/Cost Analysis; Indications for Cardiac MRI; Current Management of Heart Failure: When to Refer to Heart Failure Specialist and When is Hospice the Best Option; and Emerging Role of Digital Technology/Remote Monitoring in the Care of Cardiac Patients.

This issue of Medical Clinics of North America, guest edited by Roy Colven, MD, is devoted to Dermatology. Articles in this issue include: Topical Therapy Primer for the Non-dermatologist; The Role of Biologic Therapies in Dermatology; Commonly Used Non-biologic Systemic Therapies in Dermatology; Diseases of Skin Appendages: Acne, Alopecia, and Hyperhidrosis; Common Procedures in Dermatology; Skin Cancer Epidemiology, Detection, and Management; Psoriasis and Cardiovascular Disease; Cutaneous Adverse Drug Reactions; Consultative Inpatient Dermatology; Approach to the Patient with Diffuse Blisters; Teledermatology; Nail Disease for the Primary Care Provider; Rheumatologic Skin Disease; and Common Pediatric Skin Diseases.

In this issue of Medical Clinics, guest editor Melissa B. Weimer brings her considerable expertise to the topic of Substance Use Disorders. - Provides in-depth, clinical reviews on the latest updates in Substance Use Disorders, providing actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

This issue of Medical Clinics, guest edited by Dr. Eric Widera, is devoted to Palliative Care. Articles in this important issue include: Hospice and Palliative Care: An Overview; Goals of Care Conversations in Palliative Care: A Practical Guide; The Art and Science of Prognostication in Palliative Care; Recognizing and Managing Polypharmacy in Advanced Illness; Pain Management in those with Serious Illness; Management of Grief, Depression, and Suicidal Thoughts in those with Serious Illness; Management of Respiratory Symptoms in those with Serious Illness; Management of Gastrointestinal Symptoms in Advanced Illness; Management of Urgent Medical Conditions at the End of Life; Delirium at the End of Life; Options of Last Resort: Palliative Sedation, Physician Aid in Dying and Voluntary Cessation of Eating and Drinking; Cannabis for Symptom Management; and Self-care of Physicians Caring for Patients with Serious Illness.