Opioid Misuse: A Global Crisis

Abstract

It important not to be complacent about the opioid crisis—it continues unabated and demands renewed and focused attention. Almost 450 000 Americans died of an opioid-related overdose between 1999 and 2018. In 2017, the US Department of Health and Human Services declared the opioid crisis a national public health emergency. Approximately 1 in 100 adults in the United States have an active opioid-use disorder (OUD); 88% have not received any medication for treatment. Several studies have projected a grim outlook for the opioid epidemic in the United States; under status quo, another 480 000 people could die from fatal opioid overdose in the next 10 years. However, increased access to medications for OUD and naloxone for harm reduction could prevent 179 000 fatal opioid overdoses (38% reduction).

These statistics cannot fully express the national catastrophe of the opioid epidemic that, to put it into perspective on a national scale, shares similar staggering numbers as the coronavirus disease 2019 (COVID-19) pandemic. These 2 issues also could be interacting because the COVID-19 pandemic appears to exacerbate the opioid crisis due to severe social isolation, grief, and trauma from personal and private tragedies and the inability of many people with OUD to access the already limited number of in-person treatment centers.

This special themed section on the opioid crisis contributes to the body of knowledge that focuses on additional insights and the need to manage the crisis and planning required for the next one. With respect to prevention, Kurteva et al show that some OUD may be avoided when physicians and health systems use computer-assisted prescribing programs, as opposed to hand prescribing, for patients who are being discharged from hospitals. Computer prescribing results in fewer errors and fewer prescriptions for opioids; additional research is needed to understand more fully the causal mechanisms for these observed effects.

Authors

John Hornberger Jagpreet Chhatwal

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