Opioid Dependence A Clinical and Epidemiologic Approach download
Opioid Dependence A Clinical and Epidemiologic Approach PDF The physician’s oath begins with a commitment to risk reduction—primum non nocere. The physician’s responsibility also includes the fundamental duty to relieve suffering whenever possible. Opioids are a powerful and dangerous tool in the ther- apeutic armamentarium. Much like the homesteader’s chainsaw or the miner’s dynamite in the Last Frontier where I reside, opioids can accomplish much in the short term, although untrained and indiscriminate use invites disaster. As with most decisions in medicine, opioid therapy involves ongoing risk-bene t ratio analysis. At the beginning of the twenty- rst century, we are in a position to better evaluate previously underappreciated risks and potentially overstated bene ts (of chronic opioid therapy).
Opioid Dependence A Clinical and Epidemiologic Approach PDF download At an individual level, we are seeing prevalent recalcitrant (and likely increased) chronic pain and depression and dysfunction associated with chronic opioid use. We are becoming aware of immunosuppressive and endocrinopathic effects of this drug class that have not yet made it into standard pharmacology textbooks. We are being told that more people die today in America from opioid overdose than from automo- bile accidents. And unlike many other intervention decisions the physician must make, there are societal “ripple effects” of chronic opioid therapy. Opioids prescribed by even the best-informed and best-intentioned clinicians are diverted into the wrong hands. No other therapeutic intervention (besides benzodiazepines) even comes close to sharing the public health liability of opioids.
Opioid Dependence A Clinical and Epidemiologic Approach PDF download This book is intended to “bring the practitioner up to speed” on:
• Opioid basic science
• Current areas of drug improvement research and development
• Alternatives to opioid therapy
• Evidence-based indications for opioid therapy
• Evidence-based indications against opioid therapy
• Clinical strategies for preventing and overcoming opioid dependence.