Opioid use disorder
Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, al...
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| Published in | Nature reviews. Disease primers Vol. 6; no. 1; p. 3 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Nature Publishing Group UK
09.01.2020
Nature Publishing Group |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.
The ongoing epidemic of opioid use disorder includes, in addition to increasing global use of illicitly manufactured heroin and other opioids, a public health crisis aggravated by the over-prescribing of opioid pain medications, in North America particularly. This Primer by Strang, Volkow and colleagues discusses the risk factors of opioid use disorder, together with its epidemiology, mechanisms, diagnosis and treatment. |
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| AbstractList | Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.The ongoing epidemic of opioid use disorder includes, in addition to increasing global use of illicitly manufactured heroin and other opioids, a public health crisis aggravated by the over-prescribing of opioid pain medications, in North America particularly. This Primer by Strang, Volkow and colleagues discusses the risk factors of opioid use disorder, together with its epidemiology, mechanisms, diagnosis and treatment. Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow. Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow. The ongoing epidemic of opioid use disorder includes, in addition to increasing global use of illicitly manufactured heroin and other opioids, a public health crisis aggravated by the over-prescribing of opioid pain medications, in North America particularly. This Primer by Strang, Volkow and colleagues discusses the risk factors of opioid use disorder, together with its epidemiology, mechanisms, diagnosis and treatment. Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow. |
| ArticleNumber | 3 |
| Author | Marshall, Brandon D. L. Johnson, Kimberly Strang, John Tyndall, Mark Degenhardt, Louisa Koob, George F. Volkow, Nora D. Walsh, Sharon L. Hickman, Matthew |
| Author_xml | – sequence: 1 givenname: John surname: Strang fullname: Strang, John email: john.strang@kcl.ac.uk organization: National Addiction Centre, Institute of Psychiatry Psychology & Neuroscience, King’s College London, South London & Maudsley NHS Foundation Trust – sequence: 2 givenname: Nora D. surname: Volkow fullname: Volkow, Nora D. email: nvolkow@nida.nih.gov organization: National Institute on Drug Abuse, National Institutes of Health – sequence: 3 givenname: Louisa surname: Degenhardt fullname: Degenhardt, Louisa organization: National Drug and Alcohol Research Centre, University of New South Wales – sequence: 4 givenname: Matthew surname: Hickman fullname: Hickman, Matthew organization: Population Health Sciences, Bristol Medical School, University of Bristol – sequence: 5 givenname: Kimberly surname: Johnson fullname: Johnson, Kimberly organization: Department of Mental Health Law and Policy, College of Community and Behavioural Sciences, University of South Florida – sequence: 6 givenname: George F. surname: Koob fullname: Koob, George F. organization: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health – sequence: 7 givenname: Brandon D. L. surname: Marshall fullname: Marshall, Brandon D. L. organization: Department of Epidemiology, Brown University School of Public Health – sequence: 8 givenname: Mark surname: Tyndall fullname: Tyndall, Mark organization: School of Population and Public Health, University of British Columbia – sequence: 9 givenname: Sharon L. surname: Walsh fullname: Walsh, Sharon L. organization: Department of Behavioral Science, College of Medicine, University of Kentucky |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31919349$$D View this record in MEDLINE/PubMed |
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| PublicationPlace | London |
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| PublicationTitle | Nature reviews. Disease primers |
| PublicationTitleAbbrev | Nat Rev Dis Primers |
| PublicationTitleAlternate | Nat Rev Dis Primers |
| PublicationYear | 2020 |
| Publisher | Nature Publishing Group UK Nature Publishing Group |
| Publisher_xml | – name: Nature Publishing Group UK – name: Nature Publishing Group |
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