State Laws Regulating Prescribing of Controlled Substances: Balancing the Public Health Problems of Chronic Pain and Prescription Painkiller Abuse and Overdose

2013 ◽  
Vol 41 (S1) ◽  
pp. 42-45 ◽  
Author(s):  
Andrea M. Garcia

According to the Institute of Medicine, chronic pain affects at least 116 million adults in the United States (U.S.), which is more than the total affected by heart disease, cancer, and diabetes combined. Pain costs the nation up to $635 billion each year in medical treatment and lost productivity. It has been conceptualized as a public health problem due to its prevalence, seriousness, disparities, vulnerable populations, the utility of population health strategies, and the importance of prevention at both the population and individual levels. For many patients, treatment of pain is inadequate due to uncertain diagnoses, societal stigma, the lack of effective treatments, and inadequate patient and clinician knowledge about the best ways to manage pain. This article explores the inadequate treatment of pain in the U.S. and the subsequent rise of prescription painkiller abuse, misuse, and overdoses. This is followed by a review of the actions taken by states to regulate the prescribing of controlled substances.

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 670-676 ◽  
Author(s):  
Andrew H Rogers ◽  
Jafar Bakhshaie ◽  
Michael F Orr ◽  
Joseph W Ditre ◽  
Michael J Zvolensky

Abstract Background Chronic pain is a significant public health problem that is associated with several negative health outcomes, including increased health care cost, decreased productivity, and prescription opioid misuse. Although efforts have been made to curb the growing opioid epidemic in the United States, further research is needed to better understand individual difference factors that may be associated with greater pain and opioid misuse. Lower levels of health literacy, defined as the ability to obtain, understand, and use health information to make important decisions regarding health and medical care, has been associated with several chronic illnesses. Yet little work has examined the relationship between health literacy, pain, and opioid misuse among individuals with chronic pain. Methods The current study examined health literacy in relation to current opioid misuse, severity of opioid dependence, pain severity, and pain disability among 445 adults with chronic pain (74.6% female, Mage [SD] = 38.45 [11.06] years). Results Results indicated that health literacy was significantly negatively associated with each of the criterion variables. Conclusions These results suggest that health literacy may contribute to opioid misuse and pain experience among individuals with chronic pain. Interventions targeting health literacy among individuals with chronic illness may help to address the opioid public health crisis.


HPHR Journal ◽  
2014 ◽  
Vol 2014 (3) ◽  
Author(s):  

The killings of Rumain Brisbon, Tamir Rice, Akai Gurley, Dante Parker, Michael Brown, Eric Garner, and many other Black Americans, have brought global attention to racial inequities involving police brutality in the United States. The subsequent non-indictments resulting from the grand juries in Ferguson and Staten Island as well as the bombing outside a NAACP chapter in Colorado have left many Americans outraged. The Editorial Board of the Harvard Public Health Review recognizes that racism has driven health inequities among historically underserved and marginalized populations nationwide, evidenced not only in the extraordinarily disparate rate at which Blacks are killed at the hands of the police compared to Whites, but also through inequities in environmental exposures, limitations in access to health care, and other factors that affect optimal health and well-being. Indeed, Eric Garner died after a police officer violently compressed his neck and chest. This officer’s actions severely limited his ability to breathe, which already had been compromised by asthma, obesity, and hypertensive cardiovascular disease—diseases that occur at substantially higher rates among Blacks than Whites. As the Institute of Medicine (IOM) has noted, the role of racism in undermining Black health is undeniable.


Author(s):  
Joshua S. Hundert ◽  
J. Kevin Tucker

The magnitude of the public health problem due to chronic kidney disease (CKD) in the United States is gaining recognition. More than 19 million adult Americans, or 11%, have CKD, the majority with stage 1–3 disease. Many of the complicating features traditionally described in the end-stage kidney patient (ESRD) population are increasingly being noted in chronic kidney disease patients. It is now understood that complications of CKD develop earlier in the course and lead to adverse outcomes in their own right. CKD thus becomes a systemic disorder as it progresses. The major complications of CKD to be discussed—hypertension, cardiovascular disease, anemia, and bone-mineral disorders—are consistently found and are to a degree independent of the primary cause of the kidney disease.


2021 ◽  
pp. 237337992098726
Author(s):  
Siobhan Hickling ◽  
Alexandra Bhatti ◽  
Gina Arena ◽  
James Kite ◽  
Justin Denny ◽  
...  

COVID-19 has altered public health higher education and its impact on pedagogy will be felt long into the future. In response to social distancing measures, teaching academics implemented a number of changes to curricula. It is important to better understand and begin to evaluate these changes, as well as set a course for future changes to public health curricula both during and after the pandemic to best enable transformative learning. Teaching academics have an understanding of academic hierarchies and student perceptions and are well placed to provide insights into current and future changes to pedagogy in response to the pandemic. A survey was developed to examine changes that academics had made to their teaching in response to COVID-19. Responses were received from 63 public health teaching academics from five universities in Australia, the United States, and Canada. Public health teaching academics rapidly implemented a number of changes to their teaching, including alterations that enabled online teaching. The great majority of changes to teaching were related to tools or techniques, such as synchronous tutorials delivered in a video meeting room. There remains further work for the public health pedagogy community in reevaluating teaching aims and teaching philosophies in light of the COVID-19 pandemic. This could include examination of the weighting of different topics, including communicable diseases, in curricula. A series of questions to assist academics reformulating their curricula is provided. Public health teaching evolved rapidly to meet the challenges of COVID-19; however, ongoing adaptation is necessary to further enhance pedagogy.


Author(s):  
Olukayode James Ayodeji ◽  
Seshadri Ramkumar

The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.


2009 ◽  
Vol 3 (S2) ◽  
pp. S160-S165 ◽  
Author(s):  
Jeanne S. Ringel ◽  
Melinda Moore ◽  
John Zambrano ◽  
Nicole Lurie

ABSTRACTObjective: To assess the extent to which the systems in place for prevention and control of routine annual influenza could provide the information and experience needed to manage a pandemic.Methods: The authors conducted a qualitative assessment based on key informant interviews and the review of relevant documents.Results: Although there are a number of systems in place that would likely serve the United States well in a pandemic, much of the information and experience needed to manage a pandemic optimally is not available.Conclusions: Systems in place for routine annual influenza prevention and control are necessary but not sufficient for managing a pandemic, nor are they used to their full potential for pandemic preparedness. Pandemic preparedness can be strengthened by building more explicitly upon routine influenza activities and the public health system’s response to the unique challenges that arise each influenza season (eg, vaccine supply issues, higher than normal rates of influenza-related deaths). (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S160–S165)


2021 ◽  

Distracted driving is defined in the Oxford English Dictionary as “the practice of driving a motor vehicle while engaged in another activity, typically one that involves the use of a mobile phone or other electronic device.” However, other distractions not involving the use of a cell phone or texting are important as well, contributing to this burgeoning public health problem in the United States. Examples include talking to other passengers, adjusting the radio or other controls in the car, and daydreaming. Distracted driving has been linked to increased risk of motor vehicle crashes (MVCs) in the United States, representing one of the most preventable leading causes of death for youth ages 16 to 24 years. Undoubtedly, the proliferation of cell phone, global positioning system (GPS), and other in-vehicle and personal electronic device use while driving has led to this rise in distracted driving prevalence. This behavior has impacted society—including individual and commercial drivers, passengers, pedestrians—in countless numbers of ways, ranging from increased MVCs and deaths to the enactment of new driving laws. In 2016, for example, 20 percent of all US pediatric deaths (nearly 4,000 children and adolescents) were due to fatal MVCs. It has been estimated that at any given time, more than 650,000 drivers are using cell phones or manipulating electronic devices while driving. In the United States, efforts are underway to reduce this driving behavior. In the past two decades, state and federal laws have specifically targeted cell phone use and texting while driving as priority areas for legal intervention. Distracted driving laws have become “strategies of choice” for tackling this public health problem, though their enforcement has emerged as a major challenge and varies by jurisdiction and location. Multimodal interventions using models such as the “three Es” framework—Enactment of a law, Education of the public about the law and safety practices, and Enforcement of the law—have become accepted practice or viewed as necessary steps to successfully change this behavior caused by distractions while driving. This Oxford Bibliographies review introduces these and other aspects (including psychological influences and road conditions) of distracted driving through a presentation of annotated resources from peer- and non-peer-reviewed literature. This selective review aims to provide policymakers, program implementers, and researchers with a reliable source of information on the past and current state of American laws, policies, and priorities for distracted driving.


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