In pain A bioethicist's personal struggle with opioids

Travis N. Rieder

Book - 2019

A bioethicist's memoir of opioid dependence and withdrawal exposes the American health care system's failures at managing the use of opioids for pain relief and reveals the lack of resources and structures to handle the nationwide epidemic of opioid addiction.

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Subjects
Published
New York, NY : Harper, an imprint of HarperCollinsPublishers [2019]
Language
English
Main Author
Travis N. Rieder (author)
Edition
First edition
Physical Description
xiii, 297 pages ; 24 cm
Bibliography
Includes bibliographical references (pages [265]-284) and index.
ISBN
9780062854643
  • Author's Note
  • Part I.
  • Chapter 1. A Salvage Situation
  • Chapter 2. Pain and Drugs
  • Chapter 3. The Swinging Pendulum
  • Chapter 4. The Opioid Dilemma
  • Part II.
  • Chapter 5. Abandoned
  • Chapter 6. Dependence and Addiction
  • Chapter 7. What Doctors Owe Patients
  • Part III.
  • Chapter 8. Recovery
  • Chapter 9. Pain, Drugs, and Doing the Right Thing
  • Chapter 10. America's Three Opioid Epidemics
  • Epilogue Making a Difference
  • Acknowledgments
  • Notes
  • Index
Review by Kirkus Book Review

A debilitating accident prompts a man's descent into opioid dependence.Rieder (Toward a Small Family Ethic, 2016, etc.), the assistant director for Education Initiatives at the Johns Hopkins Berman Institute of Bioethics, retraces the aftermath of a traumatic 2015 accident that shattered his foot and forced him to endure six grueling surgeries. Eventually, the author was sent home with a stockpile of opioid painkillers for his excruciating pain. Rieder doesn't skimp on the grisly post-surgical details, including "the boiling pain of carved tissue" or how "coming out of anesthesia was basically the process of discovering how awful it was to be conscious." Sprinkled among the chronological chapters of his recovery are fascinating sections in which the author discusses the historical narrative of opioids, racial differences in pain assessment, and the intricate mechanics of physical pain, that "fiery, boiling, acidic" suffering that Rieder knows well. As he recovered, his physician advised him to wean himself off the high doses of oxycodone he was taking. The author describes weeks of agonizing withdrawal symptoms, including insomnia, nausea, cold sweats, and terrifying emotional darkness, which, as a new father to a young daughter, left him unable to care for her at home. Though he fortunately overcame his opioid dependence, Rieder believes he is one of the lucky ones and that improved withdrawal management and behavioral intervention programs must be mandated in hospitals to "help patients escape the grip of this medication." Later in the book, the author takes a critical detour to skillfully address the primary challenge facing opioid-prescribing physicians: initiating dependency while dutifully attempting to alleviate severe patient discomfort. Rieder recognizes in himselfand others, including his mother, who had knee replacement surgerythe dilemma facing the medical community: treating patients in pain with dangerously addictive medications responsible for killing thousands yearly. With this smart, riveting, real-life account, the author proves himself a convincing and effective advocate for opioid use reform.A harrowing cautionary narrative that speaks to patients and physicians alike on the ugly reality of the enduring opioid epidemic. Copyright Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.