Opioid Use, Overuse, and Abuse in Otolaryngology

This issue of Otolaryngologic Clinics, Guest Edited by Drs. Anna A. Pashkova, Peter F. Svider, and Jean Anderson Eloy, is devoted to Pain Management for the Otolaryngologist. This issue is one of six selected each year by our series Consulting Editor, Sujana S. Chandrasekhar. Articles in this important issue include: Overview of Pain Management for the Otolaryngologist; Pre-Operative Optimization; Local Blocks and Regional Anesthesia in the Head and Neck; Acute Pain Management following Head and Neck Surgery; Acute Pain Management following Sleep Surgery; Perioperative Analgesia for Thyroid and Parathyroid Surgery; Perioperative Analgesia for Sinus Surgery; Perioperative Analgesia following Otologic Surgery; Acute Pain Management following Facial Plastic Surgery; Perioperative Analgesia for Pediatric Patients Undergoing Otolaryngologic Procedures; Non-Opioid Adjuncts and Alternatives; Postoperative Analgesia in the Chronic Pain Patient; Non-Enteral Pain Management; Chronic Pain Management in the Head and Neck Patient; Controlled Substance Agreements; Pain Psychology; Sinus Headache; and Quality Improvement in Pain Medicine.

The most comprehensive, multi-disciplinary text in the field, Cummings Otolaryngology: Head and Neck Surgery, 7th Edition, provides detailed, practical answers and easily accessible clinical content on the complex issues that arise for otolaryngologists at all levels, across all subspecialties. This award-winning text is a one-stop reference for all stages of your career—from residency and board certification through the challenges faced in daily clinical practice. Updated content, new otology editor Dr. Howard W. Francis, and new chapters and videos ensure that this 7th Edition remains the definitive reference in today’s otolaryngology. Brings you up to date with the latest minimally invasive procedures, recent changes in rhinology, and new techniques and technologies that are shaping patient outcomes. Contains 12 new chapters, including Chronic Rhinosinusitis, Facial Pain, Geriatric Otology, Middle Ear Endoscopic Surgery, Pediatric Speech Disorders, Pediatric Cochlear Implantation, Tongue-Ties and Lip Ties, Laryngotracheal Clefts, and more. Covers recent advances and new approaches such as the Draf III procedure for CRS affecting the frontal recess, endoscopic vidian and posterior nasal neurectomy for non-allergic rhinitis, and endoscopic approaches for sinonasal and orbital tumors, both extra- and intraconal. Provides access to 70 key indicator (Accreditation Council for Graduate Medical Education Key Indicator Procedures), and surgical videos – an increase of 43% over the previous edition. Offers outstanding visual support with 4,000 high-quality images and hundreds of quick-reference tables and boxes.

Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery – Pediatric Otolaryngology is part of a multi-volume textbook covering basic and clinical science across the entire field of otolaryngology. Volumes in the set include; otology, neurotology and skull-based surgery; rhinology, allergy and immunology; facial plastic and reconstructive surgery; laryngology and head and neck surgery. The full set is enhanced by over 5000 full colour images and illustrations, spanning nearly 6000 pages, complete with a comprehensive index on DVD. Edited by Robert T Sataloff from Drexel University College of Medicine, Philadelphia, this volume includes contributions from internationally recognised experts in otolaryngology, ensuring authoritative content throughout. Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery – Pediatric Otolaryngology is an indispensable, in-depth guide to the field for all otolaryngology practitioners. Key Points Textbook of paediatric otolaryngology, part of six-volume set covering the entire field of otolaryngology Volumes include otology/neurotology, rhinology, plastic surgery, laryngology, head and neck surgery, and paediatric otolaryngology Over 5000 full colour images and illustrations across six volumes Edited by Robert T Sataloff, with contributions from internationally recognised otolaryngology experts

Master the basics of diseases in a flash! This unique package of text, flash cards, and interactive exercises online at DavisPlus (davisplus.fadavis.com) provides all of the elements needed to build a basic understanding of more than 430 diseases and disorders.

The Second Edition of Patient Care Management Lab develops and fine tunes pharmacy and pharmacy technician students' skills in reading, evaluating, and filling prescriptions. The chapters correspond to particular disease states, summarizing the key characteristics and concerns with the associated drugs. At the core of the learning experience are patient cases in which students assume the role of the dispensing pharmacist or pharmacy technician. Each case presents a new patient and a new prescription to fill. Students must first assess the completeness of the patient profile and then evaluate possible complications. Each chapter features at least 20 cases. Students also learn how to counsel patients based on their prescription orders and drug and social histories. NEW TO THIS EDITION: All of the prescriptions in the text have been reviewed for currency and revised with the latest information. More than 350 new prescriptions have been added to the book to give students experience with a broader range of drugs. Puzzles and Problems appendix asks students to evaluate 36 prescriptions that are difficult to decipher or, if filled as written, could be harmful. New Answer Key available on the text's thePoint site provides Pharmacy instructors with detailed, suggested responses to each case found within the textbook.

This text offers an authoritative account of general medical and surgical conditions as they apply to the practice of dentistry and oral healthcare. Now established as the standard reference on the subject, Medical Problems in Dentistry is essential for students learning for the first time or practitioners needing to keep up-to-date with their knowledge. Detailed coverage outlines the complete relevance of systemic diseases and their treatment to dentistry – essential knowledge for the whole dental team User-friendly format allows ease of access to information whether for exam revision purposes or for a specific issue confronting staff in a busy clinical environment Clearly written with excellent use of illustrations, the book is an essential, easy to use, reliable source of information Text completely updated and re-organised to increase focus on the more dentally-relevant aspects of medicine and subject areas that have undergone recent change Entries more fully alphabetized to improve access to information Accompanying ‘key points boxes’ highlight the most crucial aspects of specific medical conditions Content peer-reviewed by a specialist Advisory Board to ensure accuracy of information and the inclusion of the latest advances Additional coverage of autoinflammatory disorders, biological response modifiers, craniofacial transplantation, drug reactions, drug-resistant microbial infections, osteonecrosis, and immune reconstitution syndrome Completely new entries such as alternative and complementary medicine, health promotion, men’s issues and occupational health New national and international guidelines, selected recent references and up-to-date websites

The Essence of Analgesia and Analgesics is an invaluable practical resource for clinicians giving pain relief in any clinical setting, describing the pharmacologic principles and clinical use of all available pain medications. As well as detailed overviews of pain processing and analgesic theory, sections are dedicated to oral and panteral opioid analgesics, neuraxial opioids, NSAIDs, local anesthetics, anticonvulsant type analgesics, NMDA antagonists, alpha adrenergic analgesics, antidepressant analgesics, muscle relaxants, adjuvant medications, and new and emerging analgesics. The concise format of the chapters allows for quick and easy reading and assimilation of information. Enhanced by summary tables and figures, each chapter provides an overview of a particular drug, covering chemical structure, mode of activity, indications, contraindications, common doses and uses, advantages and disadvantages, and drug related adverse events. Key references are also provided. Edited by leading experts in pain management, this is essential reading for any clinician involved in pain management.

This book is written for any clinician who encounters substance abuse in a patient and wonders what to do. Experts from a cross-section of specialties and health professions provide up-to-date, evidence-based guidance on how non-expert clinicians can recognize, understand, and approach the management of substance abuse in their patients. They detail the range of treatments available and whether and how they work. The central importance of using a carefully selected multimodal approach that is tailored to the individual patient is emphasized throughout and illustrated in case scenarios from actual clinical practice.

Integrative Addiction and Recovery offers an authentic model of comprehensive integrative modalities germane and specific to the field of addiction and recovery treatment. Although many treatment services for addiction include "holistic," "alternative," or "integrative" in their descriptions, they contain no substantive programs or services consistent with the mind, body, spirit paradigm contained within the integrative approach to health and healing. Consequently, many patients do not have the opportunity to benefit from the true spirit of an integrative approach within the discipline of addition and recovery medicine. This book sets the standard for a bona fide integrative approach for others to follow, providing information that is immediately useful in clinical practice and rigorously evidence-based. Authored by world-class experts in the field of addiction medicine, Integrative Addiction and Recovery presents both scientific and holistic data regarding a wide variety of holistic and conventional approaches to the treatment of substance abuse and behavioral addictions. Its chapters cover both conventional and holistic treatment and provide background for each of the major classes of drugs of abuse, including opiates, alcohol, tobacco, stimulants, sedative-hypnotics, hallucinogens and marijuana. It also includes chapters on the topics of food addiction and behavioral addictions such as gambling and shopping. The authors explore the major holistic modalities, providing background and theory in areas like acupuncture, Traditional Chinese Medicine, Homeopathy, Aromatherapy, and Ayurvedic Medicine, while at the same time providing spiritual approach chapters on Shamanism and Ibogaine, as well as more conventional issues with a holistic view including Co-Occurring Disorders and Psychosocial Treatment, and Group Support. The very complex issue of chronic pain and addiction is also addressed, along with relapse prevention strategies.

"Dave Chase is the first and just about only person that's ever been able to give me hope and a real pathway to fundamental change in our convoluted health care system." ― Paul Shoemaker, Founding President of Social Venture Partners International, Author of Can't Not Do: The Compelling Social Drive that Changes Our World. Named one of the "Top 50 Most Influential People in the Nonprofit Sector" by The NonProfit Times, and "Philanthropist of the Year" by Future in Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The opioid crisis is not an anomaly. Instead, it's a self-inflicted wound, driven by a catastrophically dysfunctional health care system, leading to what has become the largest public health crisis in 100 years. Fortunately, proven antidotes exist -- all created and spearheaded by forward-looking citizen leaders and employers. It's time to scale these solutions nationwide, stop the crisis in its tracks and move us light years closer to solving the larger disaster that is our health care system.As you read this, countless people are leaving clinics and hospitals with over 30-day supplies of opioids for lower back pain, and other diagnoses for which opioids have little evidence of helping. Further, people are receiving opioid prescriptions for procedures where evidence-based medicine doesn't justify such as many spinal procedures and asymptomatic wisdom tooth removal.We need to mobilize the resources necessary to help those already enslaved by opioid use disorders. At the same time, we also need to turn off the enormous flow of people becoming addicted. Only by traveling upstream to stop addiction before it starts will we ever clean up the opioid crisis--and prevent future floods of addiction. In The Opioid Crisis Wake-Up Call, Dave Chase explores the already-existing solutions to the largest public health crisis in a 100 years, updating and expanding on the content and themes from his 2017 bestseller, The CEO's Guide to Restoring the American Dream. Here he uncovers the upstream fixes designed to stop the crisis at its source. Chase's message is this: resolving the opioid crisis, at the CEO, citizen, and community level, brings us miles closer to fixing the systemic failures of U.S. health care.

The book begins with a public health/epidemiologic examination of the situation, with a systematic view of the problem based on classic (infectious disease) epidemiologic principles applied to this behavioral health issue. This application is expanded to take into account the fact that unlike most epidemics in our species’ history, a unique factor that must be accounted for in any public health analysis is that the host (opioid-dependent/misusing patient) is generally not under sufficiently strong motivation to avoid the disease. The introduction concludes with a survey of recent containment approaches, categorized epidemiologically by target (agent, vector, host.) The remainder of the book is organized according to this framework, addressing agent, vector/transmission and host, respectively. Sections Three and Four comprise the major focus of the book, and are dedicated primarily to practical education for primary care providers in preventing opioid use disorder, and overcoming it after the fact.

Methadone and buprenorphine are the only two opioids that are indicated for the management of both pain and opioid-related drug addiction. Both present unique challenges to the general practitioner and pain specialist, requiring a separate analysis from the rest of the drugs in the same family. Handbook of Methadone Prescribing and Buprenorphine Therapy is an invaluable guide to the safe use of these opioids. Authored by clinical and academic leaders from a variety of settings and backgrounds, this book includes chapters on pharmacology, adverse effects, safe rotation from other opioids, cardiac toxicity, prescribing, pharmacokinetics, equianalgesic dose and replacement therapy. This comprehensive text provides clinicians, researchers, policy-makers and academicians a resource for all the relevant points in methadone prescribing and buprenorphine therapy.

"This book is a 'must have' resource in every physician/clinician practice setting."--Martin Grabois, M.D., Professor of PM&R, Baylor College of Medicine, Houston,TX. Dr. Vasudevan draws upon an accumulated reservoir of clinical expertise to provide readers with an up-to-date and highly readable guide to multidisciplinary pain management. . . . If only this book was available years ago"--Francis J. Keefe, PhD. Professor of Psychology, Psychiatry and Anesthesiology, Duke University, Durham, NC. This practical volume brings multidisciplinary innovations to the treatment of chronic pain. It argues expertly for the benefits of a biopsychosocial approach over current pain treatments more suited to acute care. The author's insights into the complexity of chronic pain and critiques of common but inconsistent unimodality pain management methods underscore the need for targeted multi-disciplinary pain programs. Among a wealth of useful clinical nuggets, readers will find guidance on adding "virtual" support to a pain management team, details on ways patients can take an active role in dealing with their chronic pain, and the original concept of the "back attack." Included in the coverage: Pain theories and factors behind chronic pain—its application in treatment. Cognitive behavioral coping strategies. Treatments that have questionable or controversial evidence. Evaluation of disability in patients with chronic pain. Creating a virtual multidisciplinary team. Common pain problems: low back pain, complex regional pain syndrome, myofascial pain syndrome, fibromyalgia. Multidisciplinary Pain Management will enhance the work of diverse practitioners, including health and clinical psychologists, family and other primary care physicians, psychiatrists, occupational and physical therapists, and rehabilitation specialists.

This mid-sized reference is an essential guide for diagnosing and managing children's diseases in day-to-day practice. Provides quick access to diagnoses via presenting signs and symptoms and utilizes a problem-oriented format to focus on problems seen in practice. Focuses on primary care including the interface with specialists.

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.

Since the publication of the Institute of Medicine (IOM) report Clinical Practice Guidelines We Can Trust in 2011, there has been an increasing emphasis on assuring that clinical practice guidelines are trustworthy, developed in a transparent fashion, and based on a systematic review of the available research evidence. To align with the IOM recommendations and to meet the new requirements for inclusion of a guideline in the National Guidelines Clearinghouse of the Agency for Healthcare Research and Quality (AHRQ), American Psychiatric Association (APA) has adopted a new process for practice guideline development. Under this new process APA's practice guidelines also seek to provide better clinical utility and usability. Rather than a broad overview of treatment for a disorder, new practice guidelines focus on a set of discrete clinical questions of relevance to an overarching subject area. A systematic review of evidence is conducted to address these clinical questions and involves a detailed assessment of individual studies. The quality of the overall body of evidence is also rated and is summarized in the practice guideline. With the new process, recommendations are determined by weighing potential benefits and harms of an intervention in a specific clinical context. Clear, concise, and actionable recommendation statements help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. The new practice guideline format is also designed to be more user friendly by dividing information into modules on specific clinical questions. Each module has a consistent organization, which will assist users in finding clinically useful and relevant information quickly and easily. This new edition of the practice guidelines on psychiatric evaluation for adults is the first set of the APA's guidelines developed under the new guideline development process. These guidelines address the following nine topics, in the context of an initial psychiatric evaluation: review of psychiatric symptoms, trauma history, and treatment history; substance use assessment; assessment of suicide risk; assessment for risk of aggressive behaviors; assessment of cultural factors; assessment of medical health; quantitative assessment; involvement of the patient in treatment decision making; and documentation of the psychiatric evaluation. Each guideline recommends or suggests topics to include during an initial psychiatric evaluation. Findings from an expert opinion survey have also been taken into consideration in making recommendations or suggestions. In addition to reviewing the available evidence on psychiatry evaluation, each guideline also provides guidance to clinicians on implementing these recommendations to enhance patient care.

This is the first book devoted to the study of the social and economic consequences of headache. Reducing the Public Burden of Headache analyses the financial cost of headache diseases, the disability and suffering they cause and the impact they have on the quality of life and the sufferers and their families. These are issues of major importance; migraine appears in the top 20 list of diseases ranked according to years lived with the disability. Headache, in general, is thought to account for approximately 20% of all days lost from work. Of even greater importance is the impact on everyday life, syudies have shown that migraine has a greater impact on the quality of life of sufferers than many other diseases generally considered to be more serious. This book describes and analyses the epidemiological data accumulated in the field and suggests guidelines and interventions aimed at improving healthcare for headache. Adoption of these suggestions combined with judicious use of existing resources and modern treatment options can lead to great improvements in the lives of headache sufferers world-wide. This book will be of interest to neurologists, general practitioners, epidemiologists, public health specialists, health service managers and all those interested in improving services and outcomes for sufferers of headache.

This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.

This annual report prepared by The Board provides a comprehensive account of the global drug situation, analyses trends in drug abuse and drug trafficking and suggests necessary remedial action. Divided into four parts, it covers the following topics: drugs and corruption, functioning of the international drug control system, analysis of the world situation and finally, a set of recommendations to Governments, the United Nations and other relevant international and regional organizations. A set of Annexes follows as well.