p.p1 {white-space:pre} Annotated Bibliography Amanda Lin Bakalar, Nicholas. “Alternatives

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Annotated Bibliography
Amanda Lin

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Bakalar, Nicholas. “Alternatives to Opioids for Pain Relief.” The New York Times, The New York Times, 8 Nov. 2017, www.nytimes.com/2017/11/08/well/live/alternatives-to- opioids-for-pain-relief.html.
This article gives evidence on how a combination of Tylenol and Advil worked just as well as opioids for relief of pain in the emergency room. It also lets Chang, a professor of emergency medicine at Albany Medical College, show that while any single patient might find opioids more effective, on average, even for the severe pain of fractures, non-opioids worked just as well. This source seems decently reliable as most other sources also confirm the statements in the article and it also has a professor from a college that studies medicine. This will be useful as it will support the argument that opioids can be effectively discontinued, as there are alternatives that achieve similar results.

Chen, Caroline. “Drugmakers Are Racing to Find Alternatives to Opioids.” Bloomberg.com, Bloomberg, 28 June 2017, www.bloomberg.com/news/articles/2017-06-28/life-after- opioids-drugmakers-scramble-to-concoct-alternatives.
This article shows how doctors are trying to improve pain medication, the new drugs are drawing from the known pain-modifying attributes of chili peppers and cannabis, as well as human genetic mutations that alter how people experience pain to concoct new treatments for the nation’s 100 million chronic sufferers. It also brings up Genentech, which is developing an oral drug based on extremely rare genetic mutations that prevent people from feeling pain. This source is slightly different from the other sources answers as it looks at possibly removing the pain sensors and prevent people from feeling pain in the name of helping people. This will be useful as it was support the argument that opioids are replaceable in the very near future, and it may be possible that pain medication in general will not be needed in the future.

Fields, Howard L. “The Doctor’s Dilemma: Opiate Analgesics and Chronic Pain.” Neuron, U.S. National Library of Medicine, 24 Feb. 2011, www.ncbi.nlm.nih.gov/pmc/articles/ PMC3073133/.
This source gives reasons that opiates are still needed and effectively treating those who have acute and severe pain following trauma, extensive burns or surgery and how they are also used for patients with painful terminal diseases such as cancer. It goes on to that that the biggest controversy regarding the issue is the misuse and abuse of prescribed opiates, but that they are still needed and effective for long term or chronic pain patients. This source not only give background information about the reasons opiates are still being used but also addresses the problem. This source will be useful as it really focuses on the controversy surrounding the misuse and abuse of the prescribed opiates. I will be able to use it in the argument that opiates are still essential to treating patients.

Gallup, Inc. “In U.S., Opioids Viewed as Most Serious Local Drug Problem.” Gallup.com, 29 July 2016, news.gallup.com/poll/194042/opioids-viewed-serious-local-drug- problem.aspx.
This source gives lots of evidence and statistics on the opioid crisis before the governments and state leaders started cracking down. It also shows how more Americans see prescription painkillers and heroin as a crisis or very serious problem in their area compared to other drugs. This source focuses more on how opioids affect local areas, and is more on the statistics and opioids in general. It is useful if I want to help support the argument that opioids are dangerous and harmful to people as it has killed so many people. It’s helped me realize that opioids in general have killed so many people throughout history.

Han, Beth, et al. “Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults.” Annals of Internal Medicine, American College of Physicians, 5 Sept. 2017, annals.org/aim/article- abstract/2646632/prescription-opioid-use-misuse-use-disorders-u-s-adults-2015
A research funded by the U.S. Department of Health and Human Services show that most opiate misuse were adults who had low income, or had behavioral health problems, and the most common reason for misuse was the desire to remove physical pain. The emphasizes how people are only doing what they are doing due to discomfort. This will help as it looks a lot at who, how and where the drugs are being misused. 

Hobson, Jeremy. “Seeking Solutions To The Growing Opioid Epidemic.” Seeking Solutions To The Growing Opioid Epidemic | Here & Now, 18 Apr. 2017, www.wbur.org/hereandnow/ 2017/04/18/opioid-epidemic-solutions.
This article puts most of the blame on the misuse of prescribed opiates and how patients and clinicians have tended to overestimate the effectiveness of prescription opioids for the treatment of chronic non-cancer pain, and also underestimated their risks. It also goes back to the origin, where the vast majority of current heroin users report that prescription opioids were their first opioid of abuse. This source takes a new look at the opiates, specifically how people have overestimated their effectiveness and underestimates the risks. It also helps as it gives a glimpse into the history of opiates. This source will be useful, as it provides some background to opiates months before world leaders took over on containing the crisis.

Kertesz, Stefan, and Sally Satel. “The Opioid Crackdown Is Making Life Miserable-Even Untenable-for People With Chronic Pain.” Slate Magazine, 17 Aug. 2017, www.slate.com/articles/health_and_science/medical_examiner/2017/08/ cutting_down_on_opioids_has_made_life_miserable_for_chronic_pain_patients.html.
This article gives evidence that opioids are not an appropriate first line treatment for long term pain, and what happens when people who are used to having the opioids dampen their pain suddenly have it removed. This article really shows that there are people whose pain is so great they would commit suicide without the opioids. This adds the problem of how effective the alternatives will be for chronic pain, thus supporting the argument that opioids are still needed.

Kosten, Thomas R., and Tony P. George. “The Neurobiology of Opioid Dependence: Implications for Treatment.” Science & Practice Perspectives, National Institute on Drug Abuse, July 2002, www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/.
This source gives evidence on how brain abnormalities resulting from chronic use of heroin, oxycodone, and other morphine-derived drugs, and how they are the underlying causes of opioid dependence (the need to keep taking drugs to avoid a withdrawal syndrome) and addiction (intense drug craving and compulsive use). It goes further to explain that even though a cure for drug addiction is unlikely long-term treatment can limit the disease’s adverse effects and improve the patient’s day-to-day functioning. Not only does this look into how the brain works, and how the brain depends on the drugs it really explains how the opioids affect the patients long term. This source would help the argument that opioids need to be replaced with a new less harmful drug as soon as possible.

MS, Andrew K. Chang MD. “Single-Dose Oral Opioid and Nonopioid Analgesics for Acute Extremity Pain.” JAMA, American Medical Association, 7 Nov. 2017, jamanetwork.com/ journals/jama/article-abstract/2661581 .
This source was a clinical trial that shows that there were no statistical significant or clinical important differences in pain reduction at two hours among single-dose treatment with ibuprofen and acetaminophen or with three different opioid and acetaminophen combination analgesics. This is one of the first sources I found that gave a solid solution to how opiates could be effectively switched out. This is especially important as this proves that there is a substitute out there that can do what the opioids do, with less negative side effects. This will be useful for the argument that the opioids can be switched as there is an alternative readily available.

“Opiate Pain Relievers for Chronic Pain.” WebMD, WebMD, 2015, www.webmd.com/pain-
This source talks not only about the different opioids but also the brands that they are sold as. It goes on to explain how the opioids suppress your perception of pain, and is used specifically to reduce moderate to severe chronic pain. Not only does it give the side effects of opioids but also tells us how well it works. This source gives information that is supported by perilously found sources and is posted and reviewed by a group of doctors. This was useful as it provided a little snippet of every aspect of the opioid crisis, and can be used to support both the need to discontinue the use of opioids and the issue that some still need to use opioids.

“National Center for Health Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 21 Dec. 2017, www.cdc.gov/nchs/products/databriefs/ db294.htm.
This source gives evidence on the amount of deaths caused by opiates and other drug abuse. The data goes on to show that the amount of deaths due to opioids have increased dramatically from 2015 to 2016. This source should be reliable as it is a government site that specializes in disease control and prevention. The statistics in this source could be used to support either side of the argument, though it mostly supports the side that argues that we can stop using opiates as there as better alternatives out there.

National Institute on Drug Abuse. “Is the Use of Medications like Methadone and Buprenorphine Simply Replacing One Addiction with Another?” NIDA, www.drugabuse.gov/ publications/principles-drug-addiction-treatment-research-based-guide-third-edition/ frequently-asked-questions/use-medications-methadone-buprenorphine.
This source shows how the use of methadone and buprenorphine have gradual onsets of action and help produce stable levels in the brain. As a result, patients maintained on these medications do not experience the rush or euphoria thus reducing their desire to use opioids. This source is decently reliable as it is a government source dedicated to drug abuse reports. This gives 2 more solutions to opioids, though they may not be a long term substitution, they do provide the damper on ones thirst for opioids.

Park, Alice. “Non Opioid Pain Relievers Just As Effective as Opioids, Finds Study.” Time, Time, 7 Nov. 2017, time.com/5012393/non-opioid-pain-relievers-just-as-effective-as-opioids/.
This source explains how doctors are now being more careful as they prescribe opioids, as even short term use of opioids can lead to long term addiction. Doctors have also found that a combination of ibuprofen and acetaminophen (Tylenol) is just as effective as an opioid painkiller. This source should be recently reliable as most other sources also agree with this information. This source is yet again in support of using non opioid pain relievers, and gives a plausible alternative and why people should switch to the non opioid. This is useful as it provides, yet another, possible alternative for non opioid painkillers.

Park, Alice. “Opioids: 60% of People Who Misuse Don’t Have a Prescription.” Time, Time, 31 July 2017, time.com/4881191/mmost-people-who-misuse-opioids-dont-have-a- prescription/.
This source explains how the over prescribing of opioids can lead to excess medications that can then be passed on, intentionally or unintentionally, to others who might abuse them. While prescribing the powerful pain killers for less serious conditions can also lead to such diversion and abuse. This source gives slightly different percentages as the ones before, but it is understandable as they are taken at different times. It also presents the same problems as other sources, and is showing that many people misuse the drug. This article would be helpful as it gives statistics on how many drug abusers are not prescribed to the drug. It is also in a generally neutral position though it could be used to argue that the opioids should continue to be prescribed as less misuse of the drug are from people with prescriptions who actually need the drug.

“Treatment of Opioid Dependence.” World Health Organization, World Health Organization, www.who.int/substance_abuse/activities/treatment_opioid_dependence/en/.
This sources gives evidence that no single treatment is effective for all individuals with opioid dependence, diverse treatment options are needed, including psychosocial approaches and pharmacological treatment. This source should be reliable as it is from the World Health Organization, and it focuses on treatments other than another drug it suggests a more diverse treatment plan. This source was useful as it helped me realize that there was another aspect that i could focus on yet again, the psychosocial aspect. The source will support the argument that requires a new alternative due to the fact that the old treatments are resulting in dependance and addictions.

Urban, Kylie. “Medications, Mindfulness and More Alternatives to Opioids for Treating Pain.” Opioid Alternatives: Chronic Pain Treatment & Opioid Addiction, U Of M, healthblog.uofmhealth.org/health-management/medications-mindfulness-and-more- alternatives-to-opioids-for-treating-pain.
This source talks about how opioid is a common treatments though it comes at the cost of potential worse pain and function, plus dependence or addiction. It goes on to say that the evidence showing opioids to be effective in the treatment of chronic pain is lacking and that there are numerous studies indicate the significant risks associated with the drugs. The sources information should be decently reliable as it is published by a college, and the information presented does support the rest of the information that show that opioids are the common treatment for chronic pain and how it can cause dependence or addiction.  This source will be useful as it supports the use of alternative methods to opioids, but instead of giving a new drug this source suggests mindfulness and focusing not only the physical but also the mental aspects of the pain.