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The path that Dr. Jerome Adams took to the office of U.S. surgeon general begins in this southern Maryland town, where crab restaurants dot the rural landscape, where signs warn drivers to watch out for Amish horse-drawn buggies, and where he grew up on a rolling road with three siblings, including a brother five years his junior. Phillip. But as Jerome’s career has taken flight — he’s won scholarships for college and medical school, taken charge of a state health department, and ascended to become “the nation’s doctor,” as his job is nicknamed — Phillip’s has been diverted. (Joseph, 12/7)

Surgical patients can get as good or better pain relief with a fraction of the amount of opioids typically prescribed, a group of doctors reports. In 170 gallbladder operations from January 2015 to June 2016, they found that patients left the hospital with an average of 250 milligrams of opioids in 40 pills. Within a year, patients had taken an average of 30 milligrams of opioids, sometimes along with Tylenol or ibuprofen. Their median score on a 10-point pain scale was 5. (Bakalar, 12/7)

The first step, [Dr. Muhammad] Farhan explains, is getting them over the idea that they can eliminate pain entirely. He says this expectation can be especially dangerous for people who rely on increasing doses of opioids. ... Farhan says opioids have their place – right after surgery or an injury, say, or for cancer pain. But for patients with issues like back pain or other long-term problems, he favors non-opioid drugs and treatments. Many of these treatments by themselves don’t have the same pain-reducing effects as high-voltage opioids. So he pairs them with mind-body techniques like meditation, hypnosis, biofeedback and yoga to help patients control stress, which can make pain worse. (Smith, 12/6)

Nashville Mayor Megan Barry's administration lined up a a law firm to explore a potential lawsuit against manufacturers and distributors of prescription opioids, but members of the Metro Council's Minority Caucus delayed the hiring at Tuesday's council meeting. They contend that the procurement was not transparent and have raised questions about the selection, including whether Metro reached out to minority-led firms about the request for proposals. (Garrison and Reicher, 12/6)

What do you say to people like Jeff and Sue Shesto? What do you say to neighbors you've known for years, whose daughter has died of a heroin overdose? A girl who grew up right in front of your eyes, a girl who might have watched your cat while you were out of town, who might have babysat for your kids, who might have waved at you just the other day as you drove by her house. What do you say to that pretty young woman's devastated mom and dad? (Stephenson, 12/6)

The Milwaukee County medical examiner's office responded to three probable drug overdose deaths Wednesday, two in Milwaukee and one in Racine County, an official at the office said. (Garza, 12/6)