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.
A revelatory, moving narrative that offers a harrowing critique of the war on drugs from voices seldom heard in the conversation: drug users who are working on the front lines to reduce overdose deaths When the news began to break (and break) about the impending opioid epidemic, the story was reliably about despair, addiction, and death. As the story developed to include the criminal actions of Big Pharma, and the heartbreak of relatives who had lost loved ones to overdoses, it continued to leave out one vital perspective: that of the drug users fighting to live--and to help others live as well. Across the country, drug users are organizing themselves in response to the growing number of overdose deaths and demanding that addicts be given the same rights as other citizens. Set against the backdrop of the overdose crisis Light Up the Night provides an up-close look at how drug users navigate policies that criminalize them through the ongoing failed war on drugs. It chronicles a growing social change movement led by drug user activists whose goal is to save lives, end stigma, and inspire common sense policy-making. Told from embedded reporting focused on two local activists, Jess Tilley in Massachusetts and Louise Vincent in North Carolina, this is the story of the courageous people stepping in where the government's public health policies have failed, standing on the front lines of the underground effort to help drug users use drugs safely, reduce harms, and live with dignity.
Providing an indispensable resource for undergraduate students, graduate students, and policymakers interested in the prescription drug abuse crisis in the United States, this book summarizes the current state of prescription drug abuse and its growth over the past 20 years. The Prescription Drug Problem analyzes the growth of the prescription drug abuse problem from 1994 to 2014 and includes comparisons to marijuana and hard drug use during the same period. Specific attention is given to prescription opiate abuse and the transition from prescription opiates to heroin. The book begins with a broad overview of the prescription drug problem in the U.S., while the text presents stories of celebrities who have struggled with prescription drug abuse, highlights a handful of ordinary Americans who are battling prescription drug abuse, and examines as case studies a few communities that have been ravaged by prescription drug abuse. Drawing upon demographic patterns of abuse to identify causes of and factors contributing to prescription drug abuse as well as possible solutions to the problem, the book is designed to provide a broad overview of the prescription drug abuse problem in the U.S. and stimulate additional research.
A four-year investigation into the world of synthetic drugs—from black market factories to users & dealers to harm reduction activists—and what it revealed. A deeply human story, Fentanyl, Inc. is the first deep-dive investigation of a hazardous and illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding government agencies that are challenged to combat it. “A whole new crop of chemicals is radically changing the recreational drug landscape,” writes Ben Westhoff. “These are known as Novel Psychoactive Substances (NPS) and they include replacements for known drugs like heroin, cocaine, ecstasy, and marijuana. They are synthetic, made in a laboratory, and are much more potent than traditional drugs” —and all-too-often tragically lethal. Drugs like fentanyl, K2, and Spice—and those with arcane acronyms like 25i-NBOMe—were all originally conceived in legitimate laboratories for proper scientific and medicinal purposes. Their formulas were then hijacked and manufactured by rogue chemists, largely in China, who change their molecular structures to stay ahead of the law, making the drugs’ effects impossible to predict. Westhoff has infiltrated this shadowy world. He tracks down the little-known scientists who invented these drugs and inadvertently killed thousands, as well as a mysterious drug baron who turned the law upside down in his home country of New Zealand. Westhoff visits the shady factories in China from which these drugs emanate, providing startling and original reporting on how China’s vast chemical industry operates, and how the Chinese government subsidizes it. Poignantly, he chronicles the lives of addicted users and dealers, families of victims, law enforcement officers, and underground drug awareness organizers in the United States and Europe. Together they represent the shocking and riveting full anatomy of a calamity we are just beginning to understand. From its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many. “Timely and agonizing. . . . An impressive work of investigative journalism.” —USA Today “Westhoff explores the many-tentacled world of illicit opioids, from the streets of East St. Louis to Chinese pharmaceutical companies, from music festivals deep in the Michigan woods to sanctioned ‘shooting up rooms’ in Barcelona, in this frank, insightful, and occasionally searing exposé. . . . Westhoff’s well-reported and researched work will likely open eyes, slow knee-jerk responses, and start much needed conversations.” —Publishers Weekly “Our 25 Favorite Books of 2019” —St. Louis Post-Dispatch “Best Books of 2019” —Buzzfeed “Best Nonfiction of 2019” —Kirkus Reviews “50 Best Books of 2019” —Daily Telegraph “Best Nonfiction Books of 2019” —Tyler Cowen “Best Books of 2019” —Yahoo Finance
The inside story of a band of entrepreneurial upstarts who made millions selling painkillers—until their scheme unraveled, putting them at the center of a landmark criminal trial. • SOON TO BE THE MAJOR MOTION PICTURE PAIN HUSTLERS STARRING EMILY BLUNT AND CHRIS EVANS "Unfolds with the velocity and verve of a Scorsese film…A tour de force."—Patrick Radden Keefe, New York Times bestselling author of Empire of Pain and Say Nothing John Kapoor had already amassed a small fortune in pharmaceuticals when he founded Insys Therapeutics. It was the early 2000s, a boom time for painkillers, and he developed a novel formulation of fentanyl, the most potent opioid on the market. Kapoor, a brilliant immigrant scientist with relentless business instincts, was eager to make the most of his innovation. He gathered around him an ambitious group of young lieutenants. His head of sales—an unstable and unmanageable leader, but a genius of persuasion—built a team willing to pull every lever to close a sale, going so far as to recruit an exotic dancer ready to scrape her way up. They zeroed in on the eccentric and suspect doctors receptive to their methods. Employees at headquarters did their part by deceiving insurance companies. The drug was a niche product, approved only for cancer patients in dire condition, but the company’s leadership pushed it more widely, and together they turned Insys into a Wall Street sensation. But several insiders reached their breaking point and blew the whistle. They sparked a sprawling investigation that would lead to a dramatic courtroom battle, breaking new ground in the government’s fight to hold the drug industry accountable in the spread of addictive opioids. In The Hard Sell, National Magazine Award–finalist Evan Hughes lays bare the pharma playbook. He draws on unprecedented access to insiders of the Insys saga, from top executives to foot soldiers, from the patients and staff of far-flung clinics to the Boston investigators who treated the case as a drug-trafficking conspiracy, flipping cooperators and closing in on the key players. With colorful characters and true suspense, The Hard Sell offers a bracing look not just at Insys, but at how opioids are sold at the point they first enter the national bloodstream—in the doctor’s office.
Now a major TV series on Disney+ 'A shocking investigation... Dopesick is essential' The Times 'Unfolds with all the pace of a thriller' Observer 'A deep – and deeply needed – look into the troubled soul of America' Tom Hanks 'Essential reading' New York Times Beth Macy reveals the disturbing truth behind America's opioid crisis and explains how a nation has become enslaved to prescription drugs. This powerful and moving story explains how a large corporation, Purdue, encouraged small town doctors to prescribe OxyContin to a country already awash in painkillers. The drug's dangerously addictive nature was hidden, whilst many used it as an escape, to numb the pain of of joblessness and the need to pay the bills. Macy tries to answer a grieving mother's question – why her only son died – and comes away with a harrowing tale of greed and need.
A New York Times Critics’ Top Ten Book of the Year * 2021 Edgar Award Winner Best Fact Crime * A Lit Hub Best Book of The Year From a Pulitzer Prize–winning investigative reporter at the Charleston Gazette-Mail, a “powerful,” (The New York Times) urgent, and heartbreaking account of the corporate greed that pumped millions of pain pills into small Appalachian towns, decimating communities. In a pharmacy in Kermit, West Virginia, 12 million opioid pain pills were distributed in just three years to a town with a population of 382 people. One woman, after losing her brother to overdose, was desperate for justice. Debbie Preece’s fight for accountability for her brother’s death took her well beyond the Sav-Rite Pharmacy in coal country, ultimately leading to three of the biggest drug wholesalers in the country. She was joined by a crusading lawyer and by local journalist, Eric Eyre, who uncovered a massive opioid pill-dumping scandal that shook the foundation of America’s largest drug companies—and won him a Pulitzer Prize. Part Erin Brockovich, part Spotlight, Death in Mud Lick details the clandestine meetings with whistleblowers; a court fight to unseal filings that the drug distributors tried to keep hidden, a push to secure the DEA pill-shipment data, and the fallout after Eyre’s local paper, the Gazette-Mail, the smallest newspaper ever to win a Pulitzer Prize for investigative reporting, broke the story. Eyre follows the opioid shipments into individual counties, pharmacies, and homes in West Virginia and explains how thousands of Appalachians got hooked on prescription drugs—resulting in the highest overdose rates in the country. But despite the tragedy, there is also hope as citizens banded together to create positive change—and won. “A product of one reporter’s sustained outrage [and] a searing spotlight on the scope and human cost of corruption and negligence” (The Washington Post) Eric Eyre’s intimate portrayal of a national public health crisis illuminates the shocking pattern of corporate greed and its repercussions for the citizens of West Virginia—and the nation—to this day.
Why medication-assisted treatment, the most effective tool for battling opioid addiction, is significantly underused in the United States. Bronze Winner of the 2021 IPPY Book Award in Health/Medicine/Nutrition, Gold Winner of the 2020 Foreword INDIES Award in Health America's addiction crisis is growing worse. More than 115 Americans die daily from opioid overdoses, with half a million deaths expected in the next decade. Time and again, scientific studies show that medications like Suboxone and methadone are the most reliable and effective treatment, yet more than 60 percent of US addiction treatment centers fail to provide access to them. In The Opioid Fix, Barbara Andraka-Christou highlights both the promise and the underuse of medication-assisted treatment (MAT). Addiction, Andraka-Christou writes, is a chronic medical condition. Why treat it, then, outside of mainstream medicine? Drawing on more than 100 in-depth interviews with people in recovery, their family members, treatment providers, and policy makers, Andraka-Christou reveals a troubling landscape characterized by underregulated treatment centers and unnecessary ideological battles between twelve-step support groups and medication providers. The resistance to MAT—from physicians who won't prescribe it, to drug courts that prohibit it, to politicians who overregulate it—showcases the narrow-mindedness of the system and why it isn't working. Recounting the true stories of people in recovery, this groundbreaking book argues that MAT needs to be available to anyone suffering from opioid addiction. Unlike other books about the opioid crisis, which have largely focused on causal factors like pharmaceutical overprescription and heroin trafficking, this book focuses on people who have already developed an opioid addiction but are struggling to find effective treatment. Validating the experience of hundreds of thousands of Americans, The Opioid Fix sounds a loud call for policy reforms that will help put lifesaving drugs into the hands of those who need them the most.
Examines OxyContin, the so-called miracle prescription drug that swept the nation but led to overdoes and addiction, providing a look at the multi-billion-dollar pain managment business, its excesses and its abuses.
