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"For many young people, the opioid epidemic is mired in confusion: they hear about pain pills and other opioids from such a dizzying array of sources that they struggle to untangle fact from fiction. This engaging and accessible guide begins by demystify drugs and explaining the essentials about opioids and addiction. The text then builds on this foundation by teaching readers the dangers of opioids and how to get help if a loved one is addicted. This straightforward and illuminating guide will equip readers with the tools they need to enjoy a safer, smarter, and healthier future"--

Front Cover -- OPIOIDS -- Opioids -- VOLUME 4 OF NEUROBIOLOGY OF ADDICTION SERIES: -- NEUROBIOLOGY OF ADDICTION SERIES OPIOIDS -- Copyright -- Contents -- Preface -- References -- Acknowledgments -- VOLUME FOUR - Opioids -- 1. Definitions -- 2. History of opioid use, misuse, and addiction -- 3. Medical use and behavioral effects -- 4. Pharmacokinetics -- 5. Addiction potential -- 6. Behavioral mechanism of action -- 7. Neurobiological effects -- References -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W -- Z -- Back Cover.

Intro -- Cover -- Title -- Copyright -- Contents -- Chapter 1: How Opioids Work -- Chapter 2: Understanding Addiction -- Chapter 3: Consequences of Opioid Abuse -- Chapter 4: Seeking Treatment -- Chapter 5: Living in Recovery -- Glossary -- For More Information -- For Further Reading -- Index -- About the Author -- Backcover.

The opioid crisis has become far more serious than some of the other epidemics the country has faced. Patients are being prescribed opioids for pain too often and for too long, with insufficient oversight in terms of administering the drug, which can lead to abuse. In addition, if an adult is prescribed 30 days of opioids but uses the medication for only two days, the rest of it may sit in a medicine cabinet. If a teen has access to the leftovers, there is potential for abuse. So, what alternatives to opioids are available to pediatricians caring for patients in pain? This collection of timely AAP journal articles, blog posts, and policy explores the risks and possible solutions. Adapted from AAP News article "Opioid Crisis a 'Silent Killer': What Pediatricians Can Do" from September 15, 2017

What is the opioid crisis? / Sarah E. Ludwig -- The history and potential future of the opioid crisis / Amie L. Severino, Arash Shadfar, Joshua K. Hakimian, Oliver Crane, Ganeev Singh, Keith Heinzerling, and Wendy M. Walwyn -- Drug consumption facilities can provide a better solution to the opioid epidemic / Jarrett Zigon -- From opioids to heroin: how patients transition to heroin / Chris McGreal -- Many of the opioids hitting the streets come from criminal labs in China / Kathleen McLaughlin -- Despite what many believe, doctors are not the cause of the opioid crisis / Sally Satel -- Opioids cannot be the ultimate solution in pain treatment / Timothy J. Atkinson, Jennifer H. Scruggs and Tracey L. Perkins -- As cases of opioid addiction increase, so do cases of sex trafficking / Kristin Detrow -- Analyzing how the opioid crisis affects different groups can lead to its solution / Paola Scommegna -- Pill mills are putting patients at risk and letting them fall through the cracks / Malia Cole -- What does declaring the opioid crisis a public health emergency entail? / Greg Allen and Amita Kelly -- Efforts to make naloxone widely available are more difficult than anticipated / Jake Harper.

What Caused the Opioid Crisis? -- America Has a Long History of Opioid Addiction / Erick Trickey -- The Modern Pharmaceutical Industry Caused the Opioid Crisis / Eve Cable -- A Unique Set of Circumstances Made the Opioid Crisis Particularly Deadly / Sarah DeWeerdt -- The Effects Opioids Have on the Brain Make Them Particularly Dangerous / StoneRidge -- Economic Despair in the US Led to Increased Opioid Addiction and Overdose Deaths / Clark Merrefield -- What Are the Demographics of the Opioid Crisis? -- Rural Communities Are Hit Particularly Hard by the Opioid Crisis / Pew Charitable Trusts -- The Effect of the Opioid Crisis on Urban Populations Has Been Ignored / Carla R. Jackson -- Healthcare Disparities Caused More White Patients to Be Prescribed Opioids than Black Patients / Claudia López Lloreda -- Black Patients Are Getting Left Behind in Opioid Treatment / Kaitlin Sullivan -- Women Are More Likely to Experience Opioid Use Disorder / Krystina Murray -- Men Are at Higher Risk of Overdosing on Opioids / Brown University -- Who Is Responsible for the Opioid Crisis, and Can They Be Held Accountable? -- The US Federal Government Has Led Civil and Criminal Investigations into the Opioid Crisis / United States Department of Justice -- The US Government Is Also Responsible for the Opioid Crisis / Brian Mann -- Pharmaceutical Companies Share the Blame for Damage Caused by the Opioid Crisis / Francie Diep -- Many Americans Hold Doctors Responsible for Opioid Crisis / Dylan Scott -- Accountability for the Opioid Crisis Is Complicated Because Many Are Culpable / Sam Quinones -- The Sackler Family Keeps Trying to Buy Their Way out of Legal Accountability for the Opioid Crisis / Brian Mann -- Can the Opioid Crisis Be Stopped? -- Managing Pain While Reducing Opioid Use Can Help Stop the Opioid Crisis / Michael Kim -- The US Is Not the Only Country with Opioid Issues, but It Can Learn from Other Countries / Keith Humphreys, Jonathan P. Caulkins, and Vanda Felbab-Brown -- Opioids Can Be Made Harder to Abuse / Zaina Qureshi -- Drug Policies Around the World Must Be Changed to Help Beat the Opioid Crisis / Open Society Foundations -- The COVID-19 Pandemic Has Made the Opioid Crisis Worse / Dennis Thompson -- Physicians Are Taking Action to Help End the Opioid Crisis / American Medical Association.

Intro -- Foreword -- Preface -- Contents -- Contributors -- 1: Killing More than Pain: Etiology and Remedy for an Opioid Crisis -- Introduction -- Context: Origin and Growth in the Use of Opioids -- Poppies, Pain, and Panacea -- Killing More Than Pain: The Double-Edged Sword of Opioids -- Conceptual Models for Understanding Drug Epidemics -- Epidemiology of Opioid Misuse, Opioid Use Disorder, and Overdose Deaths -- Addressing Opioid Misuse, Disorders, and Overdose Deaths -- Reducing Supply and Accessibility to Opioids -- Demand Reduction: Prevention, Treatment, and Recovery Support Services -- Harm Reduction Strategies -- Conclusions and Future Directions -- References -- 2: Epidemiology: Opioid Use and Related Disorders -- Overview of the Medical Complications of Opioid Use and the Opioid Overdose Epidemic -- Drivers of the Opioid Overdose Epidemic -- Opioid Prescribing -- Nonmedical Pharmaceutical Opioid Use -- Heroin Use -- Opioid Use Disorders -- Illicitly Manufactured Fentanyl Use -- Social, Political, and Economic Factors -- Individual-Level Risk and Protective Factors for Opioid Overdose -- Opioid Dose, Potency, Duration of Action, Tolerance, and Route of Administration -- Polysubstance Use and Polypharmacy -- Benzodiazepines -- Alcohol -- Stimulants -- Underlying Psychiatric and Medical Comorbidities -- Treatment Medications -- Conclusions and Implications for Prevention -- References -- 3: Neurobiology of Addiction: A Disorder of Choice -- Introduction -- Changes in Salience Detection -- Key Systems -- Neurobiological Changes -- Behavioral Effects -- Changes in Stress Signaling -- Key Systems -- Neurobiological Changes -- Behavioral Effects -- Changes in Cognition and Control -- Key Systems -- Neurobiological Changes -- Behavioral Effects -- Neurobiology of Opioid Addiction -- Opioid-Related Neuroadaptations.

We examined the differences in neurocognitive functions in individuals dependent on heroin ( n = 120), pharmaceutical ( n = 52), and natural opioids ( n = 66) and compared with healthy controls (HC, n = 94). We estimated independent effects of the opioid groups on cognitive tests, adjusted for effect modifiers. Pharmaceutical opioid dependent group performed worse than HC in Wisconsin Card Sorting Test in conceptual level response and trials to complete first category. Pharmaceutical and heroin groups had higher error scores than HC in verbal and visual N-Back Tests (NBTs). There was no significant difference between pharmaceutical and heroin groups, but both had higher error scores than the natural opioid users in NBTs. Time to complete Trail Making- A test was higher in pharmaceutical than in natural opioid group. The natural opioid group required more trials than HC to complete the first category. Pharmaceutical opioid group had worst cognitive impairment. Cognitive functions are relatively spared in natural opioid-dependent group.