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.

A classic since its first publication nearly 25 years ago, Stoelting's Anesthesia and Co-Existing Disease, 7th Edition, by Drs. Roberta L. Hines and Katherine E. Marschall, remains your go-to reference for concise, thorough coverage of pathophysiology of the most common diseases and their medical management relevant to anesthesia. To provide the guidance you need to successfully manage or avoid complications stemming from pre-existing conditions there are detailed discussions of each disease, the latest practice guidelines, easy-to-follow treatment algorithms, and more. Presents detailed discussions of common diseases, as well as highlights of more rare diseases and their unique features that could be of importance in the perioperative period. Examines specific anesthesia considerations for special patient populations—including pediatric, obstetric and elderly patients. Features abundant figures, tables, diagrams, and photos to provide fast access to the most pertinent aspects of every condition and to clarify critical points about management of these medical illnesses. Ideal for anesthesiologists in practice and for anesthesia residents in training and preparing for boards. Includes brand new chapters on sleep-disordered breathing, critical care medicine and diseases of aging as well as major updates of nearly all other chapters. Covers respiratory disease in greater detail with newly separated chapters on Sleep Disordered Breathing; Obstructive Lung Disease; Restrictive Lung Disease; and Respiratory Failure. Provides the latest practice guidelines, now integrated into each chapter for quick reference.

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.

Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.

A second dose of Scottish charm from the author of A Wee Murder in My Shop. While business is booming at the ScotShop in Hamelin, Vermont, proprietor Peggy Winn doesn’t have time to toast her good fortune thanks to her hot-tempered, fourteenth-century Scottish companion. Being thrust into the modern world hasn’t been easy for Dirk, but Peggy is at her wit’s end trying to keep the ghostie galoot in line. But when the local police chief finds the body of Peggy’s friend Karaline’s college professor in a deserted mountain cabin, everyone is thrown for a loop. It seems the secretive professor may have been killed over his ecological work, an idea that’s only reinforced when Karaline herself is shot. Now Peggy and Dirk must set aside their differences to put the cold-blooded killer under loch and key...

The crime was unforgivable. The suspected murderer—unbelievable. One man’s pursuit of justice—unstoppable. The death of promising young pediatric AIDS researcher Eric Miller stunned the Raleigh, North Carolina, community, largely because of the horrific way he was killed. For months, Eric was slowly tortured as arsenic consumed his body. No one thought that Eric Miller’s wife, Ann—an attractive, demure, educated scientist—could be capable of such a horrible crime. No one except for veteran homicide investigator Chris Morgan, a man in the twilight of his career. But from the moment Morgan saw the thirty-year-old widow in the interview room at the police department, he knew he was seeing pure evil. Now, journalist Amanda Lamb details Morgan’s dogged investigation—a quest for the truth that would last four years and see another life taken before Ann Miller’s tangled web of death and deceit finally came to light.

An estimated 69000 people die each year from opioid overdose. Opioid overdose is easily reversed with the opioid antidote naloxone and with basic life support. Such care is generally only available in medical settings, however. These guidelines recommend that people who are likely to witness an opioid overdose, including people who use opioids, and their family and friends should be given access to naloxone and training in its use so that they can respond to opioid overdose in an emergency if a medical response is not available. Naloxone can be injected or administered intra-nasally and has minimal effects in people who have not used opioids. While naloxone administered by bystanders is a potentially life-saving emergency interim response to opioid overdose, it should not be seen as a replacement for comprehensive medical care.