A recent history of opioid use in the US: Three decades of change

Subst Use Misuse. 2019;54(2):331-339. doi: 10.1080/10826084.2018.1517175. Epub 2018 Dec 21.


Background: The opioid epidemic in the United States is a problem that has developed over decades. While clinical, regulatory, and legislative changes have been implemented to combat this issue, changes will not be immediate. Moreover, the changes that have been carried out may have unintended negative consequences such as increased use of illicit opioids (e.g., heroin and synthetics) and challenges in effective and appropriate pain management.

Objectives: This review focuses on the last three decades and presents key changes the United States has seen in the use of opioids. Conclusions/Importance: There have been numerous policy changes and programs aimed at decreasing opioid use and abuse in the United States; however, it will take a major shift in the mindset of clinicians, the general public, and policy makers to alleviate this epidemic.

Keywords: Opioid; addiction; history; opioid policy; opioid use disorder; substance abuse; substance use disorder.

Publication types

  • Historical Article

MeSH terms

  • Analgesics, Opioid / poisoning*
  • Analgesics, Opioid / therapeutic use*
  • Chronic Pain / drug therapy*
  • Chronic Pain / history
  • Drug Overdose / epidemiology*
  • Epidemics
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / history
  • Pain Management / trends
  • Practice Patterns, Physicians' / trends*
  • United States / epidemiology


  • Analgesics, Opioid