Do No Harm

Peter Segall, Andrew Kolodny, Lewis Nelson, Harry Wiland

Description

Groundbreaking Documentary: this book is based off of a documentary which has a three year deal with PBS which will be aired in three one hour segments, during which PBS will promote the book during all airings.

Opioid Epidemic: According to the CDC, there are at least 2-4 million opioid addicts and over 12 million who are opioid dependent with more than 130 people dying every day in American from opioid related overdoses. It is an issue that crosses financial, social, and political lines– affecting people from all walks of life.

Expertise: This book provides the most comprehensive and well-researched look into the faces of the opioid crisis and was written by an all-star team of experts dedicated to the medical research, policy changes, and social movements necessary to make dramatic changes in the opioid crisis.

Untold Perspective: The only all-encompassing view of opioid addiction of all books currently on the market. Through storytelling it presents all sides of the crisis while showing that positive change is possible by discussing the matter with sufferers, medical practitioners, politicians, journalists, nonprofits, educators, and many more while also shining a light on the decades-long cover ups by pharmaceutical companies.

Sujets

• Social Science
• Sociologie, société et politique
• Tratado de No Proliferación Nuclear
• Sociology
• Opioid
• NPT
• Special
• PBS
• National pipe thread
• Oxycodone

Informations

• Publié par: Turner Publishing Company
• Date de parution: 25 février 2020
• Nombre de lectures: 0
• EAN13: 9781684423255
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

DO NO HARM
DO NO HARM
The Opioid Epidemic
Harry Wiland with Peter Segall
Foreword by Georges Benjamin, MD
Preface by Andrew Kolodny, MD
T URNER P UBLISHING C OMPANY
Nashville, Tennessee
www.turnerpublishing.com
D O N O H ARM: T HE O PIOID E PIDEMIC
Copyright 2019 Media Policy Center. All Rights Reserved
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone]. Requests to the Publisher for permission should be addressed to Turner Publishing Company, 4507 Charlotte Avenue, Suite 100, Nashville, Tennessee, [phone], fax [phone], E-mail: [e-mail] .
Limit of Liability/Disclaimer of Warranty: While the publisher and the author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor the author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
Cover design: Pete Garceau
Book design: Karen Sheets de Gracia
Names: Wiland, Harry, author. | Segall, Peter, author. | Benjamin, Georges, writer of foreword.
Title: Do no harm : the opioid epidemic / by Harry Wiland, with Peter Segall ; foreword by Georges Benjamin.
Description: Nashville, Tennessee : Turner Publishing Company, [2019] | Includes bibliographical references and index. | Summary: Do No Harm: The Opioid Epidemic follows author and director, Harry Wiland as he works to unearth the history and truth behind America s rampant opioid crises, and investigates how this crisis ballooned into an epidemic fueled by Big Pharma s ploys, the medical community s obliviousness, and policymakers lack of oversight -Provided by publisher.
Identifiers: LCCN 2019025417 (print) | LCCN 2019025418 (ebook) | ISBN 9781684423231 (paperback) | ISBN 9781684423248 (hardcover) | ISBN 9781684423255 (ebook)
Subjects: LCSH: Opioid abuse-United States-History. | Opioids-Therapeutic use-United States. | Pain-Treatment-United States. | Pharmaceutical industry-United States. | Public health-United States.
Classification: LCC RC568.O45 W548 2019 (print) | LCC RC568.O45 (ebook) | DDC 362.29/30973-dc23
LC record available at https://lccn.loc.gov/2019025417
LC ebook record available at https://lccn.loc.gov/2019025418
P RINTED IN THE U NITED S TATES OF A MERICA
19 20 21 22 23 10 9 8 7 6 5 4 3 2 1
This book is dedicated to my loving daughters, Winona and Julia. They continue to make a positive difference in this challenging world we live in. Do No Harm is especially dedicated to my loving and caring wife, Holly, who encouraged me to write this book in the hope of saving even one life from the scourge of opioid addiction. My sister-in-law Wilhelmina Wiland and my brother Michael Wiland were there for me since the beginning of the project. Dennis Marony is a friend both on and off the court. Mike Fallon keeps me honest. I thank them all.
primum non nocere
( do no harm )
CONTENTS
FOREWORD by Dr. Georges Benjamin
PREFACE by Dr. Andrew Kolodny
INTRODUCTION
1 Origins of a Crisis
2 Ancient Times to Modern Medicine
3 The Science of Pain and Pain Management
4 Arthur Sackler s Marketing Tactics
5 Purdue Pharma
6 The Disease of Addiction
7 Physicians for Responsible Opioid Prescribing (PROP)
8 Understanding Addiction
9 The Survivors: Broken but Unbowed
10 Talk Therapy
11 Medically Assisted Treatment (MAT) or Abstinence?
12 Public Health Campaigns and Legal Actions
13 The Beginning of the End?
14 Changing the Culture, Ending the Crisis
EPILOGUE
APPENDIX A
APPENDIX B
APPENDIX C
APPENDIX D
ACKNOWLEDGMENTS
ENDNOTES
INDEX
ABOUT THE AUTHOR
FOREWORD
OUR NATION S EPIDEMIC of opioid misuse is at the core of consecutive drops in US life expectancy in 2016 and 2017 (a decrease we have not seen since the great influenza pandemic of 1918). The epidemic is the result of a massive systems failure concerning every element of the health industrial complex, including certain pharmaceutical companies deceptive marketing of the drugs, the complicity of a small number of clinicians who prescribed the drugs fraudulently, and a much larger number who prescribed them in an inappropriate way for pain therapy. Drug distributors, the pharmacy community, and regulators at both the federal and local levels failed to provide effective oversight for what we now know to be vast amounts of drugs being prescribed, delivered, and utilized by patients. Not surprisingly, the illegal drug market seized upon and leveraged these failures to make money by preying on vulnerable and desperate patients who then had both chronic pain and suffered from drug addiction. Like with many health problems, the complications did not stop there. For many of these patients, additional diseases like HIV/AIDS and other sexually transmitted diseases, mental health issues, and other chronic health conditions become comorbidities. Family strife, economic hardship, and other social challenges often followed. This real medical and societal mess was largely preventable had we followed that old medical adage to first, do no harm.
So where do we go from here to address this epidemic and ensure it never happens again? Overall the focus needs to cover tools to aid prevention, efforts to improve treatment, and enhanced research. Prevention would be strengthened by having better surveillance systems to track drug production, distribution, and utilization to identify abnormal patterns of both illegal and legal drug use. This is especially important for pharmaceuticals with high addictive or abuse potential. Robust state and federal data systems need to be in place to accomplish improved surveillance. Enhanced systems to monitor morbidity and mortality from drug use must better support our nation s poison control systems. Upgrading the timeliness and accuracy of our death reporting systems is essential and should include better training and accountability.
Optimizing pharmacotherapy for pain must be a higher priority. Tragically, health providers who prescribe controlled substances remain woefully under-trained in pain management. Better education about pain management, especially on managing chronic pain, is essential and should continue throughout all levels of any health provider s professional education. Evidence-based prescription guidelines are a core component of ensuring sound prescribing practices, but continued research on how to ensure patients are properly managed is also required so patients are not denied needed pain therapy. People in administrative positions have a different need and thus must be appropriately trained in oversight, quality assurance, and administration. Regulators also need specialized training in how to provide effective regulatory oversight.
There needs to be a comprehensive strategy to address abuse and enhanced national efforts to place and enforce better controls on the amounts of opioids prescribed. Such a strategy would ensure the availability of medications for therapeutic purposes and minimize the availability of illegal drugs. One such strategy already in place: prescription drug management programs that monitor dispensed drugs that contain controlled dangerous substances. These systems provide a mechanism for clinicians to verify the prescribed use of controlled substances by patients. While such monitoring programs are a good first step, more needs to be done to ensure cross state linkages, particularly in regional areas that share patient populations. Enforcement by regulatory authorities, health occupation boards, and, when necessary, law enforcement to identify, penalize, and prosecute those providers who are actively breaking the law needs to continue. More efforts to break up illegal drug distribution chains with a particular focus on online advertising and sales are needed. The health insurance industry can play an enhanced role through drug utilization monitoring, utilization review, and prior authorization. Insurer engagement with workers compensation programs for patients with chronic pain and drug assistance programs can be a valuable tool for both prevention and treatment.
Consumer education is a major need. Consumers are generally unaware of the addictive potential of these medications, and there is evidence to show that these medications are often passed around between friends, family members, and neighbors to help with pain. Youth experimentation with drugs-sometimes via leftover pills in the family medicine cabinet-is also a pathway to addiction. More drug take-back and other safe drug disposal programs would allow people to more easily remove unneeded and unwanted medications from their homes to reduce the risk of inappropriate drug usage.
Substance misuse must be medicalized and decriminalized. Treatment should become a first option for addiction, with treatment availability expanded to meet the need. Evidence-based treatment for substance misuse must become the norm. For example, medication-assisted treatment is very effective and should be more widely available. Research into new