Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Framing Opioid Prescribing Guidelines for Acute Pain written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-03-20 with total page 223 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Medications for Opioid Use Disorder Save Lives written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-06-16 with total page 175 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book VA Opioid Prescription Policy Practice and Procedures written by United States. Congress. Senate. Committee on Veterans' Affairs and published by . This book was released on 2016 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Relieving Pain in America written by Institute of Medicine and published by National Academies Press. This book was released on 2011-10-26 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book Management of Patients with Chronic Pain written by Steven F. Brena and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 309 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book has been written for the general health care professional, from every medical and paramedical specialization. Because pain is the most common factor driving patients to seek professional advice, it is likely that every physician, psychologist, and therapist has been clinically exposed to the difficulty and the frequent frustration of dealing with people in pain. All of them may find in this book some explanations for their puzzles and some updated information, which usually are published in specialized journals not ordinarily read by the general practitioner. Actually the book has been addressed to professionals at two different levels of general practice. At one level is the busy practitioner who treats most patients with' 'acute" pain, and who may use this information in daily practice to prevent the onset of chronic pain; a common effort from all professionals currently is needed to curb the "epidemic" of chronic pain in the United States. At another level the book has been addressed to the practitioner who may have a more intense desire to become involved in the actual management of chronic pain patients.

Download or read book Evaluation of the Department of Veterans Affairs Mental Health Services written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-29 with total page 467 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Download or read book Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic written by Engineering National Academies of Sciences (and Medicine) and published by . This book was released on 2019 with total page 83 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Download or read book An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-10-16 with total page 111 pages. Available in PDF, EPUB and Kindle. Book excerpt: Opioid prescriptions for acute and chronic pain increased dramatically from the late 1990s into the current decade in both the civilian and the Department of Veterans Affairs and Department of Defense treatment environments. Similarly, prescriptions for benzodiazepines also increased significantly for anxiety and insomnia. Combinations of opioid and benzodiazepines have proven fatal when taken concurrently, with research demonstrating this phenomenon for nearly 40 years. This issue is exacerbated within the veteran population because of higher rates of pain, anxiety and other related health issues due to military life. An evaluation of the relationship between opioid and benzodiazepine medication practices at the VA is necessary to improve treatment for mental health and combat-related trauma for veterans. An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides investigates the effects of opioid initiation and tapering strategies in the presence of benzodiazepines in veterans. This report explores neurobiology and the principles of addiction and tolerance, in addition to the current use of opioids and benzodiazepines for treating pain and anxiety in both the veteran and general population. It also provides a protocol to evaluate the relationship between opioid and benzodiazepine medication practices. This framework is a critical foundation for further research to improve concomitant opioid and benzodiazepine medication practices for veterans and the general population.

Download or read book Chronic Pain and Addiction written by Michael R. Clark and published by Karger Medical and Scientific Publishers. This book was released on 2011-01-01 with total page 171 pages. Available in PDF, EPUB and Kindle. Book excerpt: The relationship between chronic pain and addiction Patients with chronic pain understandably seek relief from their distress and discomfort, but many medications that alleviate pain are potentially addictive, and most chronic pain conditions only have a temporary response to opiate analgesic drugs. This volume reviews the fundamental topics that underlie the complex relationships of this controversial domain. The authors review behavioral models and practical methods for understanding and treating chronic pain and addiction including methods to formulate patients with complex comorbidity and screen patients with chronic pain for addictive liability. Finally, the authors describe the current findings from clinical and basic science that illuminate the role of opiates, cannabinoids and ketamine in the treatment of chronic pain. Up to date and comprehensive, this book is relevant to all professionals engaged in the care of patients with chronic pain or addiction and all others interested in these contemporary issues, particularly non-clinicians seeking clarity in the controversy over the best approach to patients with chronic pain.

Download or read book Extremity Trauma written by James P. Kennedy and published by . This book was released on 1992 with total page 398 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Mental Health Inc written by Art Levine and published by Abrams. This book was released on 2017-08-15 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt: The mental health system in America is hardly the front-burner issue it should be, despite lip service about reform after each new tragic mass killing. Yet every American should care deeply about fixing a system a presidential commission reported was in “shambles.” By some measures, 20 percent of Americans have some sort of mental health condition, including the most vulnerable among us—veterans, children, the elderly, prisoners, the homeless.With Mental Health, Inc., award-winning investigative journalist Art Levine delivers a Shock Doctrine-style exposé of the failures of our out of control, profit-driven mental health system, with a special emphasis on dangerous residential treatment facilities and the failures of the pharmaceutical industry, including the overdrugging of children with antipsychotics and the disastrous maltreatment of veterans with PTSD by the scandal-wracked VA.Levine provides compelling narrative portraits of victims who needlessly died and some mentally ill people who won unexpected victories in their lives by getting smart, personalized help from “pyschosocial” programs that incorporate safe and appropriate prescribing, along with therapy and social support. He contrasts their stories with corrupt Big Pharma executives and researchers who created fraudulent marketing schemes. Levine also tells the dramatic David vs. Goliath stories of a few brave reformers, including Harvard-trained psychiatrist and researcher Dr. Stefan Kruszewski, who has acted as a whistleblower in several major cases, leading to important federal and state settlements; in addition, the book spotlights pioneering clinicians challenging outmoded, drug-and-sedate practices that leave 90 percent of people with serious mental illness too disabled to work.By taking a comprehensive look at mental health abuses and dangerous, ineffective practices as well as pointing toward solutions for creating a system for effective, proven and compassionate care, Art Levine’s essential Mental Health, Inc. is a call to action for politicians and citizens alike—needed now more than ever.

Download or read book Treatment Improvement Protocol TIP 63 Medications for Opioid Use Disorder written by Substance Abuse Mental Health Services Administration/SAMHSA (U.S.) and published by Government Printing Office. This book was released on 2018-06-05 with total page 398 pages. Available in PDF, EPUB and Kindle. Book excerpt: This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration (FDA)-approved medications used to treat opioid use disorder (OUD)—methadone, naltrexone, and buprenorphine—and provides guidance for healthcare professionals and addiction treatment providers on appropriate prescribing practices for these medications and effective strategies for supporting the patients utilizing medication for the treatment of OUD. The goal of treatment for opioid addiction or OUD is remission of the disorder leading to lasting recovery. Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. This TIP also educates patients, families, and the general public about how OUD medications work and the benefits they offer. Related products: Medication-Assisted Treatment of Opioid Use Disorder: Pocket Guide A Shared Burden: The Military and Civilian Consequences of Army Pain Management Since 2001 Click our Alcoholism, Smoking & Substance Abuse collection to find more resources on this topic.

Download or read book Substance Use Disorders in the U S Armed Forces written by Institute of Medicine and published by National Academies Press. This book was released on 2013-03-21 with total page 350 pages. Available in PDF, EPUB and Kindle. Book excerpt: Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

Download or read book Implementing Evidence Based Practice in Healthcare written by Gill Harvey and published by Routledge. This book was released on 2015-03-24 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: The successful implementation of evidence into practice is dependent on aligning the available evidence to the particular context through the active ingredient of facilitation. Designed to support the widely recognised PARIHS framework, which works as a guide to plan, action and evaluate the implementation of evidence into practice, this book provides a very practical ‘how-to’ guide for facilitating the whole process. This text discusses: undertaking an initial diagnosis of the context and reaching a consensus on the evidence to be implemented; how to link the research evidence with clinical and patients’ experience and local information in the form of audit data or patient and staff feedback; the range of diagnostic, consensus building and stakeholder consultation methods that can be helpful; a description of facilitator roles and facilitation methods, tools and techniques; some of theories that underpin the PARIHS framework and how these have been integrated to inform a revised version of PARIHS Including internationally-sourced case study examples to illustrate how the facilitation role and facilitation skills have been applied in a range of different health care settings, this is the ideal text for those interested in leading or facilitating evidence based implementation projects, from the planning stage through to evaluation.

Download or read book Mindfulness oriented Recovery Enhancement for Addiction Stress and Pain written by Eric L. Garland and published by NASW Press. This book was released on 2013 with total page 206 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Human existence can be beset by a variety of negative mental states such that life seems devoid of meaning, but it can also be liberated--a meaningful life reclaimed and savored through cultivation of a higher kind of mind. This quality, mindfulness, refers to both a set of contemplative practices and certain distinct psychological states and traits, and it can be cultivated through intentional effort and training. In Mindfulness-Oriented Recovery Enhancement for Addiction, Stress, and Pain, Eric L. Garland presents an innovative program of intervention that can be put into practice by therapists working with people struggling with addiction and the conditions that underlie it. Unlike other substance abuse treatment modalities, which focus largely on relapse prevention, Mindfulness-Oriented Recovery Enhancement (MORE) concentrates on helping people to recover a sense of meaning and fulfillment in everyday life, embracing its pleasures and pain without avoiding challenges by turning to substance use. Along with chapters on the bipsychosocial model underlying MORE and the current state of research on mindfulness, this book includes a complete treatment manual laying out for clinicians, step by step, how to run MORE groups--including adaptations to address chronic pain and prescription opioid misuse-- and enhance the holistic recovery process for people striving to overcome addiction. With addiction a widespread and growing problem in our society, Mindfulness-Oriented Recovery Enhancement could not be more timely or needed. It integrates the latest research on addiction, cognitive neuroscience, positive psychology, and mindfulness into a practice that has garnered empirical support and holds the promise of release and fulfillment for those who suffer from addiction."--Publisher's website.

Download or read book 2015 Department of Defense Health Related Behaviors Survey HRBS written by Sarah O. Meadows and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report, RAND researchers review survey methods, sample demographics, key findings, and policy implications from the 2015 Health Related Behaviors Survey of active-duty service members.