In 2020, an estimated 2.7 million people aged 12 or older, in the United States had an opioid use disorder (OUD) in the past 12 months—including 2.3 million people with a prescription opioid use disorder.1 Overdose deaths involving prescription opioids more than quadrupled from 1999 through 2016 followed by significant declines reported in both 2018 and 2019, and then an increase in 2020.2,3 Besides overdose, consequences of the opioid crisis include a rising incidence of infants born dependent on opioids because their mothers used these substances during pregnancy4,5 and increased spread of infectious diseases, including HIV and hepatitis C (HCV), as was seen in 2015 in southern Indiana.6
Effective prevention and treatment strategies exist for opioid misuse and use disorder but are highly underutilized across the United States. An initiative of the Secretary of Health and Human Services (HHS)7 began in 2015 to address the complex problem of prescription opioid and heroin use. In 2017, HHS announced five priorities for addressing the opioid crisis:
- improving access to treatment and recovery services
- promoting use of overdose-reversing drugs
- strengthening our understanding of the epidemic through better public health surveillance
- providing support for cutting-edge research on pain and addiction
- advancing better practices for pain management
Effective medications exist to treat opioid use disorder: methadone, buprenorphine, and naltrexone. These medications could help many people recover from opioid use disorder, but they remain highly underutilized. Fewer than half of private-sector treatment programs offer medications for opioid use disorders, and of patients in those programs who might benefit, only a third actually receive it.9 Overcoming the misunderstandings and other barriers that prevent wider adoption of these treatments is crucial for tackling the problem of opioid use disorder and the epidemic of opioid overdose in the United States.