Caught in the Crossfire of the Syndemic.

The worsening opioid epidemic ignites infectious disease development and transmission as opioids abused by insufflation and/or injection establish a pathway for infection to the user and propagate vulnerability to diseases. The phenomenon of the synergistic collision of epidemics intensifying the load of disease constitutes a syndemic. Merrill Signer (1994) voiced the term "syndemic" to characterize the complex nexus of politics, economics, psychosocial/environmental factors, and health disparities resulting in the inner-city AIDS crisis of the 1990s. Today, the surge of opioid use puts individuals at risk for disease transmission and living the catastrophic clash wrought by the epidemics. By following a case study caught in the crossfire of epidemics, this article prompts to underscore recognition of the at-risk patient for HIV infection and to embolden care integration of prevention and treatment strategies nurses are qualified to execute.

Opiate Dependence or Addiction?: A Review of the Centers for Disease Control and Prevention Guidelines for Management of Chronic Pain.

In the wake of epidemic of opioid overdoses in the United States, patients who are receiving treatment for chronic pain with opioid have come under increasing scrutiny. The Centers for Disease Control and Prevention issued a guideline for managing chronic pain in 2016, which makes recommendations for opioids based on current evidence. This review will highlight key components of the guideline including differentiating addiction from dependence to assist nurses to better inform patient care in managing chronic pain.