Treatment Agreements, Informed Consent and the Role of State Medical Boards in Opioid Prescribing

Author's manuscript.Prescription opioid abuse has reached epidemic proportions in the United States. As a result, states have implemented policies to help reduce prescription opioid abuse and misuse through prescribing rules enforced by state licensing boards. In at least one state, the medical board has mandated the use of treatment agreements for any patients receiving opioid medications from their physicians. These agreements require physicians to urine or saliva test patients annually for drug abuse and to engage in pill counts or other methods of determining drug abuse and allow for those findings to be turned over to law enforcement, if necessary. Treatment agreements, particularly those containing these provisions, should not be adopted by state medical boards. The negative effects on the physician-patient relationship and trust in the medical encounter and the lack of evidence to suggest agreements will be effective in reducing prescription drug abuse do not support their use as a population-based strategy to prevent prescription opioid abuse

Establishment of Innovative Shared Departments to Advance Interdisciplinary Education

More and more universities are pursuing interdisciplinary academic activities that span across department and college boundaries. Administrative structures to facilitate such programs are difficult to establish within traditional university frameworks consisting of disciplinary departments and colleges. Often interdisciplinary programs are housed in a traditional disciplinary department or college, or in a standalone center reporting to a college dean or the provost. The difficulty of these structures is obtaining broad buy-in from faculty across departments and having disciplinary degree programs include interdisciplinary coursework. To overcome the difficulties described above, an innovative shared department structure that fosters collaborations to advance interdisciplinary education has been deployed at the University of New Haven. Three shared departments have been established over the last two years: (1) a college-wide department to support interdisciplinary coursework in the first two years of engineering programs; (2) a university-wide department to support entrepreneurship and innovation; and (3) a university-wide department to support health sciences. The shared departments typically have faculty whose tenure home is a traditional disciplinary department. Faculty membership is based on interest and activity level in teaching interdisciplinary courses, participating in interdisciplinary co-curricular activities, and performing interdisciplinary research. A few faculty members may be appointed full-time in a shared department. Like traditional departments, the shared departments have chairs to lead and coordinate activities. Faculty membership can vary from year-to-year depending on their level of activity in the shared department. The shared departments are responsible for approving interdisciplinary courses within their jurisdiction. The chairs of the departments are responsible for reviewing the performance of instructors teaching the interdisciplinary courses, and for providing feedback to disciplinary department chairs on the performance of faculty who are members of the shared department. To date the shared departments have facilitated the following: (1) an Entrepreneurial Engineering Living-Learning Community (LLC) for freshmen; (2) an Innovation and Entrepreneurship LLC for sophomores; (3) an integrated technical communications program across all engineering and computer science programs; (4) an integrated approach to developing entrepreneurial thinking in students across all engineering and computer science programs; (5) the development and teaching of courses on entrepreneurship; and (6) startup weekends and a business plan competition with students drawn from across the university. The detailed structure of the two shared departments and the lessons learned in establishing and operating them is described in this paper

Pain as a global public health priority

<p>Abstract</p> <p>Background</p> <p>Pain is an enormous problem globally. Estimates suggest that 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health.</p> <p>Discussion</p> <p>Despite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe.</p> <p>Summary</p> <p>The prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem.</p

Pain as a global public health priority

BackgroundPain is an enormous problem globally. Estimates suggest that 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health.DiscussionDespite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe.SummaryThe prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem