Opioid overdoses claimed nearly 70,000 lives in 2017. Unless something is done to deflect this toxic trajectory, the death toll could exceed 500,000 over the next decade. How can we successfully confront this public health menace?
Individuals may start using opioids for medical or recreational purposes. The risk of addiction increases when:
opioids are used with other drugs,
opioids are prescribed at higher doses than is medically appropriate, or
opioids are used recreationally.
Treatment can help users who become addicted. Opioid misuse increases the risk of multiple harms, including car accidents, health problems, dependence, and fatal or non-fatal overdose. RAND work presents a comprehensive view of this dynamic crisis, highlighting which stage a policy is designed to address and noting when policies focused on one stage may have unintended consequences elsewhere.
The number of Medicaid recipients receiving medication to treat opioid abuse increased sharply in the years after approval of buprenorphine, but the increase was smaller in poorer counties and areas with larger populations of black and Hispanic residents.
Evidence-based treatment for opioid use disorder includes medication assisted treatment (MAT): the use of approved medications combined with counseling, other behavioral therapies, and patient monitoring. However, a weak evidence base prevents strong conclusions about the effects of MAT for opioid use disorder on functional outcomes.