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About 7,984 results
Association Between Marijuana Use and Risk of Cancer: A Systematic Review and Meta-analysis
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2755855
JAMA Network Open; Ghasemiesfe M, et al

Nov 26th, 2019 - What is the association between marijuana use and cancer development in adults with at least 1 joint-year exposure (equivalent to 1 joint per day for 1 year)?

Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2755276
JAMA Psychiatry; Cerda M, et al

Nov 12th, 2019 - This study’s findings suggest that possible increases in the risk for cannabis use disorder among adolescent users and increases in frequent use and cannabis use disorder among adults after legalization of recreational marijuana use may raise public health concerns and warrant ongoing study.

Millions of Americans have a substance use disorder. Help is available.
https://findtreatment.gov/
SAMHSA

Nov 5th, 2019 - The Substance Abuse and Mental Health Services Administration (SAMHSA) collects information on thousands of state-licensed providers who specialize in treating substance use disorders, addiction, and mental illness.

Smoking & Tobacco Use For Healthcare Providers
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/healthcare-providers/index.html

Oct 10th, 2019 - CDC investigates outbreak of severe lung disease in patients who have recently used e-cigarette products, also known as “vaping.

E-Cigarettes and Vaping-Related Disease
https://www.nejm.org/vaping
New England Journal of Medicine;

Oct 1st, 2019 - The use of e-cigarettes has increased rapidly. Although vaping has been shown to assist with smoking cessation, cases of severe vaping-related pulmonary disease and a number of deaths have recently been reported. Here we present a collection of articles and other resources on e-cigarettes and vaping-related disease, including clinical reports and commentary.

Alarming number of heart infections tied to opioid epidemic
https://newsroom.heart.org/news/alarming-number-of-heart-infections-tied-to-opioid-epidemic

Sep 17th, 2019 - An alarming number of people nationwide are developing infections of either the heart’s inner lining or valves, known as infective endocarditis, in large part, due to the current opioid epidemic. This new trend predominantly affects young, white, poor men who also have higher rates of HIV, hepatitis C and alcohol abuse, according to new research published in the Journal of the American Heart As...

Urinary Incontinence in Women: Evaluation and Management
https://www.aafp.org/afp/2019/0915/p339.html
American Family Physician;

Sep 14th, 2019 - Urinary incontinence is a common problem among women worldwide, resulting in a substantial economic burden and decreased quality of life. The Women's Preventive Services Initiative is the only major organization that recommends annual screening for urinary incontinence in all women despite low to insufficient evidence regarding effectiveness and accuracy of methods. No other major organization ...

U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain
https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-marijuana-use-and-developing-brain/index.html

Aug 28th, 2019 - This Surgeon General Advisory emphasizes the importance of protecting the U.S. from the health risks of marijuana use in adolescence and during pregnancy.

Interventions to increase adherence to medications for tobacco dependence
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009164.pub3/full
Cochrane Database of Systematic Reviews;

Aug 15th, 2019 - Background Pharmacological treatments for tobacco dependence, such as nicotine replacement therapy (NRT), have been shown to be safe and effective interventions for smoking cessation. Higher levels of adherence to these medications increase the likelihood of sustained smoking cessation, but many smokers use them at a lower dose and for less time than is optimal. It is important to determine th...

Electronic Cigarettes: Common Questions and Answers
https://www.aafp.org/afp/2019/0815/p227.html
American Family Physician;

Aug 14th, 2019 - Electronic cigarettes (e-cigarettes) are popular devices designed to heat a liquid solution, often containing nicotine, that generates an inhaled aerosol, or vapor. e-Cigarettes have been marketed as healthier alternatives to traditional cigarettes. Thus, most adult users are current or former smokers who use e-cigarettes to reduce or quit cigarette smoking. Switching completely from cigarettes...

FDA releases long-awaited graphic cigarette warnings
https://newsroom.heart.org/news/fda-releases-long-awaited-graphic-cigarette-warnings

Aug 14th, 2019 - American Heart Association CEO Nancy Brown issued the following response to the proposed cigarette warning labels released today by the Food and Drug Administration (FDA): “The new, graphic cigarette warning labels proposed today by the FDA are a necessary and dramatic departure from the plain box warnings that have been in use for nearly 35 years. Cigarette warning labels that include atten...

Motivational interviewing for smoking cessation
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006936.pub4/full
Cochrane Database of Systematic Reviews;

Jul 30th, 2019 - Background Motivational Interviewing (MI) is a directive patient‐centred style of counselling, designed to help people to explore and resolve ambivalence about behaviour change. It was developed as a treatment for alcohol abuse, but may help people to a make a successful attempt to stop smoking. Objectives To evaluate the efficacy of MI for smoking cessation compared with no treatment, in ...

Incentives for smoking cessation
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004307.pub6/full
Cochrane Database of Systematic Reviews;

Jul 16th, 2019 - Background Financial incentives, monetary or vouchers, are widely used in an attempt to precipitate, reinforce and sustain behaviour change, including smoking cessation. They have been used in workplaces, in clinics and hospitals, and within community programmes. Objectives To determine the long‐term effect of incentives and contingency management programmes for smoking cessation. Searc...

HIV, schizophrenia, and all-cause mortality
https://www.sciencedirect.com/science/article/abs/pii/S0920996419301537?via%3Dihub
Schizophrenia Research;

Jun 26th, 2019 - Schizophrenia is a severe mental illness with important implications for morbidity and mortality. This population-based cohort study examined the impact of schizophrenia diagnoses on all-cause mortality among a sample of people living with HIV (PLHIV) and a 10% random sample of individuals living without HIV (HIV-) in British Columbia (BC), through a data linkage between the BC Centre for Excel...

Drug Overdose Deaths | Drug Overdose | CDC Injury Center
https://www.cdc.gov/drugoverdose/data/statedeaths.html

Jun 26th, 2019 - 70,237 drug overdose deaths occurred in the United States in 2017. The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).

Building Systems to Address Tobacco Use in Oncology: Early Benefits and Opportunities From the Cancer Center Cessation Initiative
https://jnccn.org/view/journals/jnccn/17/6/article-p638.xml
Journal of the National Comprehensive Cancer Network; Jenssen, B. et. al.

Jun 14th, 2019 - The 2014 Surgeon General’s report underscored the importance of helping patients with cancer quit smoking, because continued smoking after a diagnosis is causally linked to cancer-specific and all-cause mortality.1 More than 50% of patients with cancer who smoked before diagnosis continue to smoke after diagnosis and treatment,2 leading to calls from NCCN,3 ASCO,4 and the American Association f...

Binge Drinking and Prescription Opioid Misuse in the U.S., 2012–2014
https://www.ajpmonline.org/article/S0749-3797(19)30157-6/fulltext
American Journal of Preventive Medicine; Esser, M et. al.

Jun 10th, 2019 - Introduction Prescription opioids were responsible for approximately 17,000 deaths in the U.S. in 2016. One in five prescription opioid deaths also involve alcohol. Drinkers who misuse prescription opioids (i.e., use without a prescription or use only for the experience or feeling it causes) are at a heightened risk of overdose. However, little is known about the relationship between drinking ...

National Institute on Alcohol Abuse and Alcoholism - What Is A Standard Drink?
https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink

Apr 28th, 2019 - Many people are surprised to learn what counts as a drink. The amount of liquid in your glass, can, or bottle does not necessarily match up to how much alcohol is actually in your drink. Different types of beer, wine, or malt liquor can have very different amounts of alcohol content. For example, many light beers have almost as much alcohol as regular beer – about 85% as much.

National Institute on Alcohol Abuse and Alcoholism - Brochures and Fact Sheets
https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets

Apr 28th, 2019 - This section contains easy-to-read material for the public covering a wide range of alcohol-related topics. Publications listed below are online full text and free of charge unless otherwise noted.

Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013308/full
The Cochrane Database of Systematic Reviews; Lindson, N. et. al.

Apr 16th, 2019 - Background Nicotine replacement therapy (NRT) aims to replace nicotine from cigarettes to ease the transition from cigarette smoking to abstinence. It works by reducing the intensity of craving and withdrawal symptoms. Although there is clear evidence that NRT used after smoking cessation is effective, it is unclear whether higher doses, longer durations of treatment, or using NRT before cessa...

Public Policy Statement on the Ethical Use of Drug Testing in the Practice of Addiction Medicine
https://www.asam.org/docs/default-source/public-policy-statements/2019-ethical-use-of-drug-testing-in-the-practice-of-addiction-medicine.pdf?sfvrsn=75bb4bc2_4

Apr 16th, 2019 - Drug testing uses a biological sample to detect the presence of drugs and/or drug metabolites in a patient’s body. Drug tests are ordered by physicians in a range of medical specialties, but drug testing has particular utility in addiction practices. In clinical addiction medicine, drug testing can provide the treating clinician with objective information about a patient’s recent substance u...

Maternal Smoking Before and During Pregnancy and the Risk of Sudden Unexpected Infant Death
https://pediatrics.aappublications.org/content/early/2019/03/07/peds.2018-3325/
Pediatrics Anderson, T. et. al.

Mar 10th, 2019 - OBJECTIVES: Maternal smoking during pregnancy is an established risk factor for sudden unexpected infant death (SUID). Here, we aim to investigate the effects of maternal prepregnancy smoking, reduction during pregnancy, and smoking during pregnancy on SUID rates. METHODS: We analyzed the Centers for Disease Control and Prevention Birth Cohort Linked Birth/Infant Death Data Set (2007–2011: 2...

State Medical Marijuana Laws
http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx

Mar 4th, 2019 - In 1996, California voters passed Proposition 215, making the Golden State the first in the union to allow for the medical use of marijuana. Since then, 33 more states, the District of Columbia, Guam, Puerto Rico and US Virgin Islands have enacted similar laws. As of Jan. 22, 2018, the Vermont legislature passed adult-use legalization legislation and the governor signed the bill. The measure do...

Substance-Linked Sex in Heterosexual, Homosexual, and Bisexual Men and Women: An Online, Cross-Sectional “Global Drug Survey” Report
https://www.jsm.jsexmed.org/article/S1743-6095(19)30423-0/fulltext
Lawn. W., et al

Mar 1st, 2019 - Introduction Substance use in sexual contexts has received recent attention, but it has mostly been restricted to men who have sex with men and the so-called “chemsex” phenomenon. Aim To explore the use of licit and illicit substances in combination with sex in heterosexual, homosexual, and bisexual men and women; to explore substance-linked sex (SLS) differences across sexual orientation ...

Relapse prevention interventions for smoking cessation
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003999.pub5/full
Livingstone‐Banks, Jonathan

Feb 14th, 2019 - Behavioural interventions that teach people to recognise situations that are high risk for relapse along with strategies to cope with them provided no worthwhile benefit in preventing relapse in assisted abstainers, although unexplained statistical heterogeneity means we are only moderately certain of this. In people who have successfully quit smoking using pharmacotherapy, there were mixed res...

Tobacco Use By Youth Is Rising
https://www.cdc.gov/vitalsigns/youth-tobacco-use/

Feb 11th, 2019 - Tobacco product use among US youth is increasing. More than 1 in 4 high school students and about 1 in 14 middle school students in 2018 had used a tobacco product in the past 30 days. This was a considerable increase from 2017, which was driven by an increase in e-cigarette use. E-cigarette use increased from 11.7% to 20.8% among high school students and from 3.3% to 4.9% among middle school s...

A Transitioning Epidemic: How The Opioid Crisis Is Driving The Rise In Hepatitis C
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.05232?journalCode=hlthaff
Powell, D. et. al.

Feb 3rd, 2019 - The hepatitis C virus is responsible for more deaths in the United States than any other infectious disease, and hepatitis C infections have been rising at an alarming rate since 2010. We evaluated the role of the opioid epidemic and, in particular, the 2010 introduction of an abuse-deterrent version of OxyContin. The OxyContin reformulation led some users of the drug to switch to heroin, which...

Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment
https://onlinelibrary.wiley.com/doi/full/10.1111/ajad.12862
Kosten, T. et. al.

Jan 30th, 2019 - The opioid crisis has taken an immense toll in the United States. On average, five lives are lost to an opioid overdose every hour of the day; estimated costs associated with opioid misuse exceed $500 billion annually. Illicit opioid discontinuation is the first step in the treatment of opioid use disorder (OUD), and transition to an opioid agonist may initiate treatment. However, discontinuati...

E-Cigarettes and Similar Devices
http://pediatrics.aappublications.org/content/143/2/e20183652
Jenssen, B. et. al.

Jan 30th, 2019 - Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among youth. The 2016 US Surgeon General’s Report on e-cigarette use among youth and young adults concluded that e-cigarettes are unsafe for children and adolescents. Furthermore, strong and consistent evidence finds that children and adolescents who use e-cigarettes are significantly more likely to go on to use tra...

Challenges with Implementing the Centers for Disease Control and Prevention Opioid Guideline: A Consensus Panel Report
https://academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pny307/5301726?redirectedFrom=fulltext
Kroenke, K. et. al.

Jan 24th, 2019 - A national crisis of opioid-related morbidity, mortality, and misuse has led to initiatives to address the appropriate role of opioids to treat pain. Deployment of a guideline from the Centers for Disease Control and Prevention to reduce the risks of opioid therapy has raised substantial clinical and public policy challenges. The agency anticipated implementation challenges and committed to ree...

Telehealth Services
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf

Dec 31st, 2018 - The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act removes the originating site geographic conditions and adds an individual’s home as a permissible originating telehealth services site for treatment of a substance use disorder or a co-occurring mental health disorder.

Opioids in Nursing Homes
https://paltc.org/opioids%20in%20nursing%20homes

Dec 3rd, 2018 - AMDA – The Society for Post-Acute and Long-Term Care Medicine has two primary policies related to opioids in nursing homes: 1. Provide access to opioids when indicated to relieve suffering and to improve or maintain function, and 2. Promote opioid tapering, discontinuation and avoidance of opioids when the above goals are not achievable, to prevent adverse events, dependence and diversion.

MORPHABOND™ ER (morphine sulfate) Prescribing Information
https://dsi.com/prescribing-information-portlet/getPIContent?productName=Morphabond&inline=true

Nov 30th, 2018 - MORPHABOND ER is an opioid agonist indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

ROXYBOND (oxycodone hydrochloride) Prescribing Information
https://dsi.com/prescribing-information-portlet/getPIContent?productName=Roxybond&inline=true

Nov 30th, 2018 - ROXYBOND is an opioid agonist indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Three New State Laws Legalize Marijuana Use, Sparking More Confusion and Igniting Further Conflict With Federal Law
https://www.natlawreview.com/article/three-new-state-laws-legalize-marijuana-use-sparking-more-confusion-and-igniting

Nov 20th, 2018 - The mid-term elections are still on people’s minds, as recounts and run-offs for federal congressional and state gubernatorial candidates are finally wrapping up. Meanwhile, and largely taking a media-coverage backseat to these high-profile races, many new state initiatives became law as a result of the mid-terms, three which involved legalizing marijuana for recreational or medical use. Thes...

Interaction between warfarin and cannabis
https://onlinelibrary.wiley.com/doi/full/10.1111/bcpt.13152
Damkier, P. et. al.

Oct 15th, 2018 - Delta‐9‐tetrahydrocannabinol (THC), the main psychoactive cannabinoid in cannabis, may inhibit the cytochrome P450 enzyme CYP2C9. Consequently, cannabis use might infer a risk of drug‐drug interaction with substrates for this enzyme, which includes drugs known to have a narrow therapeutic window. In this study, we describe a case report of a 27‐year‐old man treated with warfarin due to mechanic...

Alcohol and Cancer Risk
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

Sep 12th, 2018 - Alcohol is the common term for ethanol or ethyl alcohol, a chemical substance found in alcoholic beverages such as beer, hard cider, malt liquor, wines, and distilled spirits (liquor). Alcohol is produced by the fermentation of sugars and starches by yeast. Alcohol is also found in some medicines, mouthwashes, and household products (including vanilla extract and other flavorings). This fact sh...

Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk
http://pediatrics.aappublications.org/content/142/3/e20181076.long
Bertrand, K. et. al.

Aug 31st, 2018 - Marijuana is the most commonly used recreational drug among breastfeeding women. With legalization of marijuana in several US states and a 1990 study in which authors documented psychomotor deficits in infants breastfed by mothers using marijuana, there is a need for information on potential exposure to the breastfed infant. Our objective with this study was to quantify cannabinoids in human m...

MORPHABOND ER Medication Guide
https://dsi.com/prescribing-information-portlet/getPIContent?productName=Morphabond%20Med&inline=true

May 31st, 2018 - MORPHABOND ER is: A strong prescription pain medicine that contains an opioid (narcotic) that is used to manage pain severe enough to require daily around-the clock, long-term treatment with an opioid, when other pain treatments such as non-opioid pain medicines or immediate-release opioid medicines do not treat your pain well enough or you cannot tolerate them.

Risk Factors for Opioid Use Disorders in Adult Postsurgical Patients
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040780/
Burcher, K. et. al.

May 10th, 2018 - The use of opioids in the treatment of chronic pain is one of the most controversial topics in medicine today. Many studies have proposed that the postoperative period is a vulnerable time for patients at risk for developing an opioid use disorder. Many patients are prescribed opioids for management of their postsurgical pain and continue using them for prolonged amounts of time following their...

Fentanyl and Other Synthetic Opioids Drug Overdose Deaths
https://www.drugabuse.gov/related-topics/trends-statistics/infographics/fentanyl-other-synthetic-opioids-drug-overdose-deaths

Apr 30th, 2018 - In 2016, synthetic opioids (primarily illegal fentanyl) passed prescription opioids as the most common drugs involved in overdose deaths in the United States.

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder
https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12609
Yatham, L. et. al.

Apr 20th, 2018 - The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously pub-lished treatment guidelines for bipolar disorder in 2005, along with international com-mentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines repre...

What Is the Evidence for “Food Addiction?” A Systematic Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946262/
Nutrients Gordon, E. et. al.

Apr 11th, 2018 - The diagnostic construct of “food addiction” is a highly controversial subject. The current systematic review is the first to evaluate empirical studies examining the construct of “food addiction” in humans and animals. Studies were included if they were quantitative, peer-reviewed, and in the English language. The 52 identified studies (35 articles) were qualitatively assessed to determine the...

Enforcing Federal Drug Laws in States Where Medical Marijuana Is Lawful
https://scholarship.law.georgetown.edu/cgi/viewcontent.cgi?article=3079&context=facpub
JAMA

Apr 9th, 2018 - On January 4, 2018, Attorney General Jeff Sessions issuedamemorandum immediately rescinding theObama Administration’s long-standing guidance limiting federal enforcement ofmedicalmarijuana.1 Federal law creates harsh penalties for the cultivation, distribution, and possession ofmarijuana, whichSessions deemed a “dangerous drug” and a “serious crime.” The memorandum places physicians and pat...

Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877694/
International Journal of Molecular Sciences;

Mar 12th, 2018 - The biological effects of cannabinoids, the major constituents of the ancient medicinal plant Cannabis sativa (marijuana) are mediated by two members of the G-protein coupled receptor family, cannabinoid receptors 1 (CB1R) and 2. The CB1R is the prominent subtype in the central nervous system (CNS) and has drawn great attention as a potential therapeutic avenue in several pathological condition...

Amphetamines
https://www.msdmanuals.com/professional/special-subjects/recreational-drugs-and-intoxicants/amphetamines
Malley, G. et. al.

Mar 1st, 2018 - Amphetamines are sympathomimetic drugs with CNS stimulant and euphoriant properties whose toxic adverse effects include delirium, hypertension, seizures, and hyperthermia (which can cause rhabdomyolysis and renal failure). Toxicity is managed with supportive care, including IV benzodiazepines (for agitation, hypertension, and seizures) and cooling techniques (for hyperthermia). There is no ster...

Binge Drinking: Predictors, Patterns, and Consequences
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104965/
Alcohol Research; White, A. et. al.

Jan 1st, 2018 - he National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of consumption that causes blood alcohol concentration to rise to .08%—the legal limit for adults ages 21 or older operating a motor vehicle—or more. This level typically occurs after a woman consumes four drinks or a man consumes five drinks—in about 2 hours. Research suggests that three out of four adole...

News - Inspirion Delivery Sciences
http://inspiriondt.com/news/

Nov 4th, 2017 - Recent News About Inspirion Delivery Sciences, a subsidiary of Inspirion Delivery Technologies. View MorphaBond™ ER Full Prescribing Information. View RoxyBond™ Full Prescribing Information

Daiichi Sankyo, Inc. and Inspirion Delivery Sciences LLC Announce Plans for Commercialization of RoxyBond™ (oxycodone hydrochloride) Tablets CII in the U.S.
https://www.daiichisankyo.com/media_investors/media_relations/press_releases/detail/006638.html

May 30th, 2017 - Daiichi Sankyo, Inc. and Inspirion Delivery Sciences LLC (Inspirion) announced today that Daiichi Sankyo will lead the U.S. commercialization of FDA-approved RoxyBond™ (oxycodone hydrochloride) immediate-release tablets, for oral use, CII with Inspirion providing additional salesforce as part of Inspirion’s co-promotion rights under the License Agreement. RoxyBond is indicated for the managemen...

ROXYBOND (oxycodone hydrochloride) Medication Guide
https://dsi.com/prescribing-information-portlet/getPIContent?productName=Roxybond_Med&inline=true

Mar 31st, 2017 - ROXYBOND is: A strong prescription pain medicine that contains an opioid (narcotic) that is used to manage pain severe enough to require an opioid pain medicine, when other pain treatments such as nonopioid pain medicines do not treat your pain well enough or you cannot tolerate them.