Pain Management For People With Serious Illness In The Context Of The Opioid Use Disorder Epidemic

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

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Board on Health Care Services,Roundtable on Quality Care for People with Serious Illness
Publisher : National Academies Press
Page : 105 pages
File Size : 47,5 Mb
Release : 2019-07-01
Category : Medical
ISBN : 9780309492263

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Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Board on Health Care Services,Roundtable on Quality Care for People with Serious Illness Pdf

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

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse
Publisher : National Academies Press
Page : 483 pages
File Size : 44,5 Mb
Release : 2017-09-28
Category : Medical
ISBN : 9780309459570

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Pain Management and the Opioid Epidemic by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse Pdf

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 Role of Nonpharmacological Approaches to Pain Management

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Global Health,Board on Health Sciences Policy,Global Forum on Innovation in Health Professional Education,Forum on Neuroscience and Nervous System Disorders
Publisher : National Academies Press
Page : 139 pages
File Size : 51,9 Mb
Release : 2019-05-23
Category : Medical
ISBN : 9780309490948

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The Role of Nonpharmacological Approaches to Pain Management by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Global Health,Board on Health Sciences Policy,Global Forum on Innovation in Health Professional Education,Forum on Neuroscience and Nervous System Disorders Pdf

Pain is a leading cause of disability globally. The dramatic increase in opioid prescriptions within the past decade in the United States has contributed to the opioid epidemic the country currently faces, magnifying the need for longer term solutions to treat pain. The substantial burden of pain and the ongoing opioid crisis have attracted increased attention in medical and public policy communities, resulting in a revolution in thinking about how pain is managed. This new thinking acknowledges the complexity and biopsychosocial nature of the pain experience and the need for multifaceted pain management approaches with both pharmacological and nonpharmacological therapies. The magnitude and urgency of the twin problems of chronic pain and opioid addiction, combined with the changing landscape of pain management, prompted the National Academies of Sciences, Engineering, and Medicine to convene a workshop on December 4â€"5, 2018, in Washington, DC. The workshop brought together a diverse group of stakeholders to discuss the current status of nonpharmacological approaches to pain management, gaps, and future directions. This publication summarizes the presentations and discussions from the workshop.

Medications for Opioid Use Disorder Save Lives

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Committee on Medication-Assisted Treatment for Opioid Use Disorder
Publisher : National Academies Press
Page : 175 pages
File Size : 48,5 Mb
Release : 2019-06-16
Category : Medical
ISBN : 9780309486484

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Medications for Opioid Use Disorder Save Lives by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Committee on Medication-Assisted Treatment for Opioid Use Disorder Pdf

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.

Opioid Therapy in Infants, Children, and Adolescents

Author : Ravi D. Shah,Santhanam Suresh
Publisher : Springer Nature
Page : 355 pages
File Size : 53,6 Mb
Release : 2020-02-21
Category : Medical
ISBN : 9783030362874

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Opioid Therapy in Infants, Children, and Adolescents by Ravi D. Shah,Santhanam Suresh Pdf

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.

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

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders
Publisher : National Academies Press
Page : 107 pages
File Size : 41,6 Mb
Release : 2018-06-22
Category : Medical
ISBN : 9780309473996

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Advancing Therapeutic Development for Pain and Opioid Use Disorders Through Public-Private Partnerships by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Neuroscience and Nervous System Disorders Pdf

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.

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 : Unknown
Page : 393 pages
File Size : 42,9 Mb
Release : 2017
Category : Chronic pain
ISBN : 0309462681

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Pain Management and the Opioid Epidemic by National Academies of Sciences, Engineering, and Medicine (U.S.). Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse Pdf

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.

Acute Pain Management

Author : Pamela E. Macintyre,Stephan A. Schug
Publisher : CRC Press
Page : 262 pages
File Size : 52,5 Mb
Release : 2021-06-20
Category : Medical
ISBN : 9781000379716

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Acute Pain Management by Pamela E. Macintyre,Stephan A. Schug Pdf

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.

Relieving Pain in America

Author : Institute of Medicine,Board on Health Sciences Policy,Committee on Advancing Pain Research, Care, and Education
Publisher : National Academies Press
Page : 383 pages
File Size : 45,6 Mb
Release : 2011-10-26
Category : Medical
ISBN : 9780309214841

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Relieving Pain in America by Institute of Medicine,Board on Health Sciences Policy,Committee on Advancing Pain Research, Care, and Education Pdf

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.

Treating Comorbid Opioid Use Disorder in Chronic Pain

Author : Annette M. Matthews,Jonathan C. Fellers
Publisher : Springer
Page : 237 pages
File Size : 53,6 Mb
Release : 2016-04-29
Category : Medical
ISBN : 9783319298634

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Treating Comorbid Opioid Use Disorder in Chronic Pain by Annette M. Matthews,Jonathan C. Fellers Pdf

​This in-depth text addresses how to approach and treat the chronic pain patient struggling with problematic opioid use. It discusses the approach for patients who may be at high risk of problematic use, such as those with a history of mental illness or substance use disorder. The first part covers diagnosis and treatment, focusing on common best practices that practitioners can adapt to any practice. Two of the chapters detail alternative and replacement therapies for opioid. Two more cover special issues in the treatment of women and older patients. The second part reviews the ethical, legal, regulatory, and policy issues surrounding the treatment of patients with comorbid pain and addiction. The book includes strategies for documentation that mitigate the risk of legal issues or ethical boundary crossings. The last part of the book addresses treating comorbid pain and opioid use disorder in different medical settings and the treatment of co-occurring mental illnesses and substance abuse. Treating Comorbid Opioid Use Disorder in Chronic Pain is of great value to psychiatrists, pain physicians, primary care providers, social workers, drug rehabilitation centers, and other behavioral health professionals. ​

Professional Nursing Concepts: Competencies for Quality Leadership

Author : Anita Finkelman
Publisher : Jones & Bartlett Learning
Page : 629 pages
File Size : 47,7 Mb
Release : 2021-12-06
Category : Medical
ISBN : 9781284230888

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Professional Nursing Concepts: Competencies for Quality Leadership by Anita Finkelman Pdf

"Professional Nursing Concepts takes a patient-centered, traditional approach to nursing education and provides the foundation pre-licensure nursing students need in order to successfully transition into practice. Grounded in the Institute of Medicine's five core competencies for healthcare professionals, the current edition logically flows from the basics of the nursing profession and the dynamics of patient care into critical healthcare delivery discussions, ranging from health policy and political action to community health and leadership in nursing practice. Each chapter features discussion questions, critical thinking activities, and "stop and consider" sections that encourage students to reflect on important chapter topics in meaningful ways. Students can further interact with text content in "Working Backwards to Develop a Case", an in-text feature that allows students to creatively apply what they have learned to their own unique case scenarios, bringing these foundational concepts to life. Above all, Professional Nursing Concepts reminds students that quality patient care is at the heart of the nursing profession. The fifth edition will continue to focus heavily on a patient-centered approach and will include new and updated features to engage students in their own learning. References will be updated as appropriate. The following changes are proposed for this fifth edition. Note that there are no new chapters planned but the text addresses some reviewer concerns, such as a need for more emphasis on community and population health perspectives and evidence-based practice"--

The Opioid Epidemic and the Therapeutic Community Model

Author : Jonathan D. Avery,Kristopher A. Kast
Publisher : Springer Nature
Page : 154 pages
File Size : 44,8 Mb
Release : 2019-10-18
Category : Psychology
ISBN : 9783030262730

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The Opioid Epidemic and the Therapeutic Community Model by Jonathan D. Avery,Kristopher A. Kast Pdf

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

The Neuroscience of Pain, Anesthetics, and Analgesics

Author : Rajkumar Rajendram,Vinood Patel,Victor R Preedy
Publisher : Academic Press
Page : 1742 pages
File Size : 52,8 Mb
Release : 2021-11-30
Category : Medical
ISBN : 9780323903134

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The Neuroscience of Pain, Anesthetics, and Analgesics by Rajkumar Rajendram,Vinood Patel,Victor R Preedy Pdf

The Neuroscience of Pain, Anesthetics and Analgesics examines the syndromes of pain and how they interlink with anesthesia and analgesics. The book covers assessments, screening and resources, and provides applications to related areas of medicine. It explores how the perception of pain results from a multifaceted interaction between illness beliefs, age, gender, time of onset, stress, socioeconomic status, and other factors. In addition, it scrutinizes how the neuroscience of pain in one condition may be relevant to understanding pain observed in other conditions. Sections address the onset of pain, the cause of pain, and the administration of analgesia or anesthesia. The book works to clarify all of the subjects pertinent to anesthesia and the brain. Featuring chapters on neurotransmitters, pharmacology and brain imaging, this volume discusses the mechanisms of pain and experimental studies undertaken to better understand the pathways involved. Includes content on the features and assessments of pain, anesthesia and analgesia Provides a mini-dictionary of terms and summary points that succinctly encapsulate each chapter Covers a broad range of topics related to the neuroscience of analgesics and anesthetics Helps readers navigate key areas for research and further clinical recommendations Features chapters on molecular pathways, imaging and a deep look at behavior associated with the experience of pain

Facing Addiction in America

Author : Office of the Surgeon General,U.s. Department of Health and Human Services
Publisher : Createspace Independent Publishing Platform
Page : 420 pages
File Size : 46,9 Mb
Release : 2017-08-15
Category : Electronic
ISBN : 1974580628

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Facing Addiction in America by Office of the Surgeon General,U.s. Department of Health and Human Services Pdf

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Framing Opioid Prescribing Guidelines for Acute Pain

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Evidence-Based Clinical Practice Guidelines for Prescribing Opioids for Acute Pain
Publisher : National Academies Press
Page : 223 pages
File Size : 49,7 Mb
Release : 2020-03-20
Category : Medical
ISBN : 9780309496872

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Framing Opioid Prescribing Guidelines for Acute Pain by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Evidence-Based Clinical Practice Guidelines for Prescribing Opioids for Acute Pain Pdf

The opioid overdose epidemic combined with the need to reduce the burden of acute pain poses a public health challenge. To address how evidence-based clinical practice guidelines for prescribing opioids for acute pain might help meet this challenge, Framing Opioid Prescribing Guidelines for Acute Pain: Developing the Evidence develops a framework to evaluate existing clinical practice guidelines for prescribing opioids for acute pain indications, recommends indications for which new evidence-based guidelines should be developed, and recommends a future research agenda to inform and enable specialty organizations to develop and disseminate evidence-based clinical practice guidelines for prescribing opioids to treat acute pain indications. The recommendations of this study will assist professional societies, health care organizations, and local, state, and national agencies to develop clinical practice guidelines for opioid prescribing for acute pain. Such a framework could inform the development of opioid prescribing guidelines and ensure systematic and standardized methods for evaluating evidence, translating knowledge, and formulating recommendations for practice.