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.

Edited by internationally recognized pain experts, this book offers 73 clinically relevant cases, accompanied by discussion in a question-and-answer format.

Some people suffer from chronic, debilitating disorders for which no conventional treatment brings relief. Can marijuana ease their symptoms? Would it be breaking the law to turn to marijuana as a medication? There are few sources of objective, scientifically sound advice for people in this situation. Most books about marijuana and medicine attempt to promote the views of advocates or opponents. To fill the gap between these extremes, authors Alison Mack and Janet Joy have extracted critical findings from a recent Institute of Medicine study on this important issue, interpreting them for a general audience. Marijuana As Medicine? provides patientsâ€"as well as the people who care for themâ€"with a foundation for making decisions about their own health care. This empowering volume examines several key points, including: Whether marijuana can relieve a variety of symptoms, including pain, muscle spasticity, nausea, and appetite loss. The dangers of smoking marijuana, as well as the effects of its active chemical components on the immune system and on psychological health. The potential use of marijuana-based medications on symptoms of AIDS, cancer, multiple sclerosis, and several other specific disorders, in comparison with existing treatments. Marijuana As Medicine? introduces readers to the active compounds in marijuana. These include the principal ingredient in Marinol, a legal medication. The authors also discuss the prospects for developing other drugs derived from marijuana's active ingredients. In addition to providing an up-to-date review of the science behind the medical marijuana debate, Mack and Joy also answer common questions about the legal status of marijuana, explaining the conflict between state and federal law regarding its medical use. Intended primarily as an aid to patients and caregivers, this book objectively presents critical information so that it can be used to make responsible health care decisions. Marijuana As Medicine? will also be a valuable resource for policymakers, health care providers, patient counselors, medical faculty and studentsâ€"in short, anyone who wants to learn more about this important issue.

Prescription Drug Diversion and Pain provides an interdisciplinary overview of medications used to treat chronic pain, specifically the benefits and risks that are posed by long-term opioids use. These essential pain-relieving medications must be carefully managed to prevent serious side effects that may include physical dependence, addiction, and even death, which has led in recent years to increased attention on the development of alternative treatments for chronic pain. This book not only offers a single, comprehensive source for understanding the specialized field of the opioid crisis, but also addresses provocative topics including how pain drugs came to be regulated by the U.S. Government and the rarely-discussed aggressive marketing behind the spread of these drugs. Chapters are written by expert contributors from diverse backgrounds in medicine, psychiatry, pharmacy, nursing, health law, and ethics. Prescription Drug Diversion and Pain is a must-read for healthcare professionals, caregivers, policy makers, regulatory officials, law enforcement, and those in the pharmaceutical industry seeking to address the current and future opioid crisis.

This book offers an in indictment of the nation's drug enforcement approach focusing on the short-sighted policies that often deny patients suffering from chronic pain the medications they need. Pain Control and Drug Policy: A Time for Change focuses on America's national crisis in pain management caused by the widening divergence between the enormous contributions of opioids ("narcotics") to pain management in the clinical setting and the mistaken belief that they are dangerous, highly addictive drugs. After dissecting the strategy and tactics of the War on Drugs from medical, historical, legal, socioeconomic, and geopolitical perspectives, Guy Faguet MD indicts the 40-year-long War on Drugs for having failed to stem the supply of illicit drugs in America despite expenditures of half a trillion dollars, despite violating the basic human right to pain relief of tens of millions of American chronic pain sufferers, and despite fomenting organized crime, government corruption, racial injustice, and social disruption in both the United States and the producer countries. He concludes with a clarion call for the abandonment of the War on Drugs, disbanding the Drug Enforcement Administration, and encouraging Congress to repeal the Controlled Substances Act. As a clinical and research oncologist responsible for the chronic pain management of thousands of cancer patients over the course of his 30-year career, Dr. Faguet knows that the most effective and safest way to manage most cases of chronic pain is with opioids. All modern pain-management textbooks advocate "titration to effect" in cases where opioids help: that is, gradually increasing the dosage until either the pain is acceptably controlled or the side effects begin to outweigh the pain-relief benefits. Yet the vast majority of doctors don't practice what the medical textbooks teach and instead prescribe opioids very reluctantly and conservatively. As a result, only half of all chronic pain sufferers-and fewer than half of all cancer patients-get adequate pain relief from their doctors. Why do physicians radically undertreat pain that is susceptible to opioid analgesics? They fear that if they prescribe Schedule II opioids in accordance with the professional standards of pain management set by such medical bodies as the American Pain Society, they will be investigated by the DEA, stigmatized, prosecuted as criminals, stripped of their licenses, and sent to jail. Visit Guy B. Faguet, MD's website here: www.faguet.net.

Thoroughly revised to reflect contemporary diagnostics and treatment, this Third Edition is a comprehensive and practical reference on the assessment and management of acute and chronic pain. This edition features 14 new chapters and is filled with new information on invasive procedures...pharmacologic interventions...neuraxial pharmacotherapy...physical and occupational therapies...diagnostic techniques...pain in terminally ill patients...cancer pain...visceral pain...rheumatologic disorders...managed care...and medicolegal issues. Reorganized with two new sections focusing on diagnostics and cancer pain. A Brandon-Hill recommended title.

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.