The Opioid Epidemic: Crisis and Solutions

Annu Rev Pharmacol Toxicol. 2018 Jan 6:58:143-159. doi: 10.1146/annurev-pharmtox-010617-052534. Epub 2017 Oct 2.

Abstract

The widespread abuse of prescription opioids and a dramatic increase in the availability of illicit opioids have created what is commonly referred to as the opioid epidemic. The magnitude of this epidemic is startling: About 4% of the adult US population misuses prescription opioids, and in 2015, more than 33,000 deaths were attributable to overdose with licit and illicit opioids. Increasing the availability of medication-assisted treatments (such as buprenorphine and naltrexone), the use of abuse-deterrent formulations, and the adoption of US Centers for Disease Control and Prevention prescribing guidelines all constitute short-term approaches to quell this epidemic. However, with more than 125 million Americans suffering from either acute or chronic pain, the development of effective alternatives to opioids, enabled at least in part by a fuller understanding of the neurobiological bases of pain, offers the best long-term solution for controlling and ultimately eradicating this epidemic.

Keywords: heroin; medication-assisted therapies; naloxone; overdose; pain; vaccines.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects*
  • Analgesics, Opioid / therapeutic use*
  • Animals
  • Chronic Pain / drug therapy*
  • Drug Overdose / prevention & control
  • Drug Prescriptions / standards
  • Humans
  • Illicit Drugs / adverse effects
  • Illicit Drugs / legislation & jurisprudence
  • Substance-Related Disorders / prevention & control
  • United States

Substances

  • Analgesics, Opioid
  • Illicit Drugs