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Joseph A. Hirsch
,
Steven Mandel
,
Kurt T. Hegmann
,
Alexandra G. Stratyner
,
Stuart Gitlow
,
James B. Talmage
, and
Christopher R. Brigham

(addictive disease). 35 Sometimes, such individuals who do not have addictive disease may nevertheless take substances in excess; however, they do not have the morbidity or mortality associated with an addictive disease. For example, an 18-year-old whose first experience with alcohol results in loss of consciousness and sudden death does not die of an addictive disease, nor does a previously drug naïve 26-year-old who experiences respiratory arrest after accidentally overdoses on fentanyl. 36 On the other hand, the death of a 45-year-old who is 6 months' sober after

in AMA Guides® Newsletter
Restricted access
James B. Talmage
and
Robert B. Snyder

pain); The effect of preoperative opioid use on postsurgical outcomes; and Whether a patient taking chronic opioid therapy is truly at maximum medical improvement (MMI) if opioid-weaning has not been tried. Introduction In 2019, 70630 drug overdose deaths occurred in the United States (US), and 70.6% involved opioids. Although the prescription opioid-involved death rate decreased slightly, from 2013 to 2019 the synthetic opioid-involved death rate increased 1,040%, primarily due to illicit fentanyl. 1 The addition of fentanyl to an opioid illicitly

in AMA Guides® Newsletter
James B. Talmage

the world's legally produced morphine and 22% of the world's legally produced fentanyl, confirming that physicians in other countries do not prescribe opioids like we in this country do. See the United Nations, Narcotic Drugs at https://www.incb.org/documents/Narcotic-Drugs/Technical-Publications/2018/INCB-Narcotics_Drugs_Technical_Publication_2018.pdf . 6. Association Between Concurrent Use of Prescription Opioids and Benzodiazepines and Overdose: Retrospective Analysis Sun EC, Dixit A, Humphreys K, Darnall BD, Baker LC, Mackey S. BMJ. 2017;356:j760

in AMA Guides® Newsletter