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 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.

Deaths involving synthetic opioids, such as fentanyl, increased from roughly 3,000 in 2013 to more than 30,000 in 2018. This book provides readers with insights intended to improve their understanding of the synthetic opioid problem.

DEA Agent Jack Riley, "[Chicago's] most famous federal agent since the days of The Untouchables" (-Rolling Stone)tells the inside story of his 30-year hunt for the drug kingpin known as El Chapo, and reveals the true causes of the American opioid epidemic. Jack Riley, grandson of a Chicago cop known for using his fists, was born to be a drug warrior. Joaquín "El Chapo" Guzmán Loera, who farmed marijuana and opium poppies as a teenager in Mexico, was born to be a drug lord. Their worlds collided when Riley, a career special agent with the Drug Enforcement Administration, was promoted to lead the fight against Chapo on the border at El Paso. Drug Warrior is the story of Riley's decades-long hunt for the world's most wanted drug lord, set against the rise of modern international drug trafficking, and America's spiraling opioid epidemic. Jack Riley started his career as an undercover street agent in Chicago busting small-time dealers. By the time he worked his way up to second in command of the DEA-a post few field agents ever reach-he had overseen every major mission to capture foreign drug kingpins since the 1990s, and had witnessed first-hand how El Chapo changed the game. As brilliant as he was lethal, Chapo not only decimated his competition, he foresaw Americans' dependence on opioids and heroin, and manipulated supply to increase demand. Riley's story culminates as he and the DEA win their greatest victory-the capture and extradition of his long-time nemesis-and Chapo faces his darkest fear: U.S. justice. A riveting memoir of life inside the drug wars, and a never-before-seen glimpse of the inner-workings of the DEA, Drug Warrior is a critical examination of how America's opioid crisis came to be, and the extraordinary people fighting it.

America has a long history of drug panics in which countless social problems have been blamed on the devastating effects of some harmful substance. In the last forty years, such panics have often focused on synthetic or designer drugs, like methamphetamine, PCP, Ecstasy, methcathinone, and rave drugs like ketamine, and GHB. Fear of these substances has provided critical justification for the continuing "war on drugs." Synthetic Panics traces the history of these anti-drug movements, demonstrating that designer chemicals inspire so much fear not because they are uniquely dangerous, but because they bring into focus deeply rooted public concerns about social and cultural upheaval. Jenkins highlights the role of the mass media in spreading anti-drug hysteria and shows how proponents of the war on drugs use synthetic panics to scapegoat society's "others" and exacerbate racial, class, and intergenerational conflict.