Medications to Treat Opioid Addiction
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An estimated 2 million people in the United States suffered from substance use disorders related to prescription opioid pain medicines in 2015. Treatment admissions linked to these medications more than quadrupled between 2002 and 2012, although only a fraction of people with prescription opioid use disorders receive specialty treatment (18 percent in 2015). Overdose deaths linked to these medicines nearly quadrupled (from 4,400 to nearly 19,000, or 1.5 to 5.9 per 100,000 persons) from 2000 to 2014. There is now also a rise in heroin use and heroin addiction as some people shift from prescription opioids to their cheaper street relative; 591,000 people had a heroin use disorder in 2015, and nearly 13,000 Americans died of a heroin overdose in 2015. Besides overdose, consequences of the opioid crisis include a rising incidence of infants born dependent on opioids because their mothers used these substances during pregnancy and increased spread of infectious diseases, including HIV and hepatitis C (HCV), as was seen in 2015 in southern Indiana.
Effective prevention and treatment strategies exist for opioid misuse and addiction but are highly underutilized across the United States. An initiative of the Secretary of Health and Human Services began in 2015 to address the complex problem of prescription opioid and heroin use. This initiative emphasizes improved education of healthcare providers in managing pain and prescribing opioids appropriately; wider availability and adoption of the effective overdose-reversing drug naloxone, which research has shown to be a lifesaver in communities where it has been distributed to people who use opioids, their families, and potential bystanders; and wider implementation of evidence-based treatment strategies.
Effective medications exist to treat opioid use disorders: methadone, buprenorphine, and naltrexone. These medications could help many people recover from opioid addiction, 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. Overcoming the misunderstandings and other barriers that prevent wider adoption of these treatments is crucial for tackling the problem of opioid addiction and the epidemic of opioid overdose in the United States.