Jane C. Ballantyne - Böcker

Long-term prescription opioid use occurs in a substantial proportion of new opioid users. Most concerning is that high risk patients with comorbid depression, anxiety, nicotine dependence, and substance use disorders, compared to patients without these factors, continue to be prescribed higher opioid doses for longer durations, and are more likely to receive opioids with high abuse potential. To understand this phenomenon, we must consider the relationships between pain, mental illness, substance use disorder and long-term prescription opioid use. While separate fields have investigated the bi-directional relationships between depression, pain, and long-term prescription opioid use independently of one another, there is no text which has brought together the complex interaction of all three together. Drawing on contributions from neuroscience, pain psychiatry, clinical epidemiology, pharmacoepidemiology, clinical trials and research on social determinants of health, Pain, the Opioid Epidemic, and Depression is the first book to integrate currently siloed areas of investigation and clinical knowledge. This book takes a comprehensive approach, from neurophysiology to epidemiology to clinical practice, and explains the processes driving maintenance of chronic pain, persistent depression, and long-term prescription opioid use, as well as taper and buprenorphine treatment for opioid use disorder. Readers will come to understand the central role of depression, other psychiatric disorders, and social determinants that contribute to pain management outcomes, the opioid epidemic, and our response to opioid dependence and opioid use disorder. By taking a multidisciplinary approach to compiling what is known about the relationships between pain, depression, other psychiatric disorders and opioids, this volume will be a valuable clinical resource for a range of healthcare and mental health professionals who encounter chronic pain and comorbid mood disorders, while also spawning new directions for researchers.

Opioid treatment for chronic pain has been popularized over the past few decades, and opioid usage has increased several-fold. Opioid treatment of chronic pain increased for several reasons: a sense that chronic pain had previously been undertreated; strong underwriting of medical education by drug companies anxious to sell new "designer" opioids; lifting of the stigma associated opioids, particularly as pain advocacy reestablished opioids as necessary and appropriate treatment for acute and cancer pain. What has emerged is that there are several limitations to chronic opioid treatment. What has become clear in this unfortunate history is that non-specialists were persuaded to prescribe opioids before they could possibly understand the complexity of the treatment. So great were the pressures to prescribe, from drug companies, advocates, and many well-meaning people who saw opioids as the panacea for suffering, opioids were prescribed indiscriminately. It became almost impossible to deny opioids without seeming inhumane. What we learned though, is that while carefully selected and managed opioid therapy can benefit certain patients, casual use fails in several respects. What is needed then is a vast educational effort to help clinicians understand some of the complexities of opioid therapy, and in particular, how to select patients, and subsequently manage and monitor so as to achieve continued efficacy without losing control of pain and drug use. While no one educational effort can solve the whole problem, this book aims to provide clinicians with expert opinion on how to manage certain common scenarios involving opioid management of chronic pain. It will provide the reader not only with an easy reference to the management of common clinical scenarios where opioids are involved, but also with in depth analysis of the difficult issues surrounding a treatment that is both uniquely effective and potentially harmful.

Selected as a Doody’s Essential Title for 2025!This exhaustively comprehensive edition of the classic Bonica’s Management of Pain , first published 65 years ago, expertly combines the scientific underpinnings of pain with clinical management. Completely revised, it discusses a wide variety of pain conditions—including neuropathic pain, pain due to cancer, and acute pain situations—for adults as well as children. An international group of the foremost experts provides comprehensive, current, clinically oriented coverage of the entire field. The contributors describe contemporary clinical practice and summarize the evidence that guides clinical practice. Substantially updated with theoretical advancements and contemporary therapies that have emerged since the previous edition published over a decade ago. Broad authorship by researchers and practitioners from the many disciplines that participate in pain medicine, including anesthesiology, neurology, physical medicine and rehabilitation, palliative care, psychology, social sciences, and more. Addresses the economic, political, legal, ethical, and sociological considerations of pain; evaluation of the pain patient; pain conditions; methods for symptomatic control; and provision of pain treatment. Packed with hundreds of full-color illustrations and tables. Enhance Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

This uniquely written title presents both the fascinating biography of Dr. John Loeser, a visionary pioneer in the field of pain medicine, as well as the compelling account of the birth and evolution of pain medicine in the United States and beyond.