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For several years, we have been a nation focused on prescription opioid reduction. In recognition of data showing steep increases in overdose rates and the need to advise prescribing clinicians, the Centers for Disease Control (CDC) issued the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. This week, the CDC published in the "New England Journal of Medicine" a key clarification of the 2016 opioid prescribing guideline. The clarification acknowledges that misapplications of the guideline and efforts to de-prescribe opioids and reduce addiction and other health risks for some Americans has backfired for many and exposed them to newer and possibly graver health risks. (Beth Darnall, 4/26)

Tapering an addictive drug takes time and there are a host of interacting factors to consider, yet as the statistics prove, the intense focus produced a real difference. This effort is not the federal government deciding what is best for patients. Rather, the federal government is acting as a responsible employer by caring about its workforce and ensuring that employees are getting the treatment and support needed for what can be a challenging recovery. (Alexander Acosta, 4/26)

Liver failure is a terrible way to die: a painful belly full of fluid, vomiting blood, mental confusion, and repeated hospitalizations. The only cure is liver transplantation but, as is the case for all types of transplants, there aren’t nearly enough donor livers to go around. This shortage raises two important questions: Who should receive a transplant? And what rights do transplant candidates have? Choosing who gets a transplant is among the most charged and challenging tasks of modern medicine. (Elliot Tapper and Michael Volk, 4/29)

Washington State Republican Sen. Maureen Walsh’s recent comment  that nurses “working at hospitals in rural regions probably play cards for a considerable amount of the day” is offensive to nurses regardless of nursing role or practice setting. (Colleen Chierici and Janice Phillips, 4/28)

My patient, an octogenarian with pneumonia and acute leukemia, was too frail to tolerate the standard treatment for his cancer, and trying to cure his pneumonia with intravenous antibiotics, when the leukemia had already compromised his immune system, would only have weakened him further. It made sense to switch him to “comfort measures”: to focus on alleviating his suffering rather than curing him. It would also make sense to have general treatment guidelines for situations like this, guidelines to indicate when comfort, not cure, is most appropriate. But no such guidelines exist. (Theresa Brown, 4/27)

What is it like to be locked into your body, to be alive but not living? I’m dying — fast. My lungs are at 20 percent of vital capacity and it’s a matter of time before the nerves supplying my breathing muscles degenerate. I have a rapid form of ALS — amyotrophic lateral sclerosis, or Lou Gehrig’s disease. Two years ago, I was running around with my kids, hiking with my wife. All that is over. My body no longer moves. I cannot talk — my only voice is the one in my head, telling me over and over that I am going to die. Soon. I can’t even breathe for myself anymore — I am tethered to a ventilator that breathes for me. (Rahul Desikan, 4/28)

If suicide is preventable, why are so many people dying from it? Suicide is the 10th leading cause of death in the United States, and suicide rates just keep rising. A few years ago, I treated a patient, a flight attendant, whose brother had brought her in to the psychiatric crisis unit after noticing her unusual behavior at a wedding. After the ceremony, she quietly handed out gifts and heartfelt letters to her family members. When her brother took her home, he noticed many of her furnishings and paintings were missing. In her bathroom he found three unopened bottles of prescription sleep medication. (Amy Barnhorst, 4/26)

In mid-April I found myself once more driving a U-Haul pickup truck from my former home on the Paradise ridge to our new digs in Sacramento. Like so many sites overwhelmed by the Camp fire in November, our place in Magalia is a pile of rubble. My wife and I went back one last time, before the bulldozer came, to see what we might gather that we'd overlooked on other visits during which we had grieved and paid respects to the little house we lived in for nearly two decades. (Jaime O'Neill, 4/29)

The extremist groups and politicians behind HB 481 have made no secret of the fact that their core objective is to ban all abortion, including in cases of rape and incest. They are wielding political power and financial clout to prop up support for their unpopular agenda and reassert control over women’s bodies. This amounts to a direct attack on Roe v. Wade, as state after state enacts an ever-increasing number of restrictions on a woman’s right to have access to safe and legal abortion. (Allison Stouffer Kopp and Toni Van Pelt, 4/27)

They were killed by acquaintances, by enemies, by accident. Some were riding their bikes, some were running for cover, some didn’t see the bullets coming. In a single year, nearly 1,200 Americans 18 and younger were victims of gun violence. The carnage has become so numbingly commonplace that most victims perish without much notice, and our collective silence is broken only by the next hail of gunfire. (Steve Lopez, 4/27)

Nicole Haynes, a USC champion heptathlete, remembers the one time in her Trojans track career when everything slowed down. She had signed into the Engemann Student Health Center because she was suffering severe stomach pains along with vomiting and diarrhea. She was ushered to an examining table, where her legs were immediately placed in stirrups. (Bill Plaschke, 4/27)