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El. knyga: Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings of a Workshop

  • Formatas: 104 pages
  • Išleidimo metai: 01-Jul-2019
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309492249
Kitos knygos pagal šią temą:
  • Formatas: 104 pages
  • Išleidimo metai: 01-Jul-2019
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309492249
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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.

Table of Contents



Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda
Acronyms and Abbreviations xix
Proceedings of a Workshop 1(1)
Introduction 1(8)
Understanding the Opioid Use Disorder Epidemic and Its Impact on Patients, Families, and Communities
9(8)
Pain Management for People with Serious Illness: Challenges and Opportunities in the Context of the Opioid Use Disorder Epidemic
17(19)
A Patient's Perspective on Opioid Use in Serious Illness
18(2)
Opioid Correction Versus Opioid Trauma: Where Policy Meets Chronic Pain
20(5)
Disparities in Access to Pain Medications
25(5)
Pain Management for Children with Serious Illness: Challenges and Opportunities in the Context of the Opioid Use Disorder Epidemic
30(3)
Discussion
33(3)
Addressing the Challenge of Patients With Comorbid Substance Use Disorder and Serious Illness
36(8)
Discussion
42(2)
Impact of Policy and Regulatory Response to the Opioid Use Disorder Epidemic on the Care of People With Serious Illness
44(12)
State Policies Addressing the Opioid Use Disorder Epidemic
45(4)
A Federal Perspective on Policies and Regulatory Approaches
49(3)
A Payer's Perspective on Policies to Address the Opioid Use Disorder Epidemic
52(1)
Discussion
53(3)
Caring for People With Serious Illness in the Context of the Opioid Use Disorder Epidemic: Lessons to Inform Policy and Practice
56(13)
Discussion
62(7)
References 69(8)
Appendix A Statement of Task 77(2)
Appendix B Workshop Agenda 79