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The Opioid Crisis: Impact, Challenges, and Paths to Recovery

  • August 28, 2023
  • Addiction, Patients and Families, Treatment
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Opioids are a class of drugs that include prescription painkillers like oxycodone and hydrocodone, illegal drugs like heroin, and synthetic opioids such as fentanyl. These substances bind to opioid receptors in the brain, producing pain relief and euphoria. Prolonged use can lead to tolerance, dependence, and addiction, characteristic of opioid use disorder (OUD). Fentanyl, due to its potency, has played a particularly lethal role in the opioid crisis.

OUD affects individuals internationally across all ages and genders. The U.S. has had a substantial increase in OUD cases, contributing to what is often referred to as the "opioid epidemic." In 2021, it was estimated that over 10 million Americans aged 12 or older misused opioids in the past year. The epidemic's roots can be traced to the late 1990s when prescription opioids became widely available. This overprescribing, coupled with the proliferation of illegal opioids like heroin and synthetic opioids such as fentanyl, has fueled the crisis.

OUD is not limited to the U.S.; it is a global issue, with varying prevalence rates in different countries. OUD has devastating health consequences. Physically, it can lead to respiratory depression, infections, constipation, and hormonal imbalances. Psychologically, individuals with OUD often experience depression, anxiety, and cognitive impairments. Socially, it can strain relationships, disrupt employment, and lead to involvement in criminal activities. The most alarming aspect is the death rate associated with OUD. Opioid overdose deaths have surged, with a significant proportion attributed to potent synthetic opioids like fentanyl. In the U.S., tens of thousands of deaths annually result from opioid overdoses, making it a leading cause of preventable deaths.

prescription opioid bottles

Preventing Opioid Use Disorder

Preventing OUD is multifaceted and requires action at various levels. Healthcare professionals must exercise caution when prescribing opioids, opting for non-opioid pain management strategies whenever possible and educating patients about the risks. There is also a need for better tracking of prescription opioids to prevent diversion to the illicit market. Community-based prevention efforts should focus on education about the dangers of opioid misuse and the promotion of safe storage and disposal of medications. Harm reduction strategies, such as needle exchange programs and the distribution of naloxone (an opioid overdose reversal drug), are crucial in preventing opioid-related deaths.

Getting Help for Opioid Use Disorder

For individuals struggling with OUD, seeking help is critical. There are multiple avenues for assistance:

  1. Medical Treatment: Medication for OUD is a highly effective approach, combining medication (such as methadone, buprenorphine, or naltrexone) with counseling and therapy. Medication helps reduce cravings and withdrawal symptoms, increasing the chances of recovery.
  2. Counseling and Therapy: Behavioral therapies, such as cognitive-behavioral therapy (CBT) and contingency management, can help individuals with OUD address the underlying psychological factors contributing to their addiction.
  3. Support Groups: Joining support groups like Narcotics Anonymous (NA) or SMART Recovery can provide a sense of community and understanding among individuals in recovery.
  4. Naloxone Access: In many places, naloxone is available without a prescription, over the counter (OTC), and should be on hand for those at risk of overdose or their family members and friends. (More about naloxone)
  5. Professional Help: Reach out to healthcare professionals, addiction specialists, or addiction treatment centers for personalized guidance and treatment options. (
  6. Emergency Services: In case of overdose, call emergency services immediately. Many jurisdictions have Good Samaritan laws that protect individuals seeking help for an overdose victim from legal repercussions.

For more information, please see APA’s page on opioid use disorder.


John A. Fromson, M.D.

Member, APA Council on Addiction Psychiatry
Vice Chair for Community Psychiatry, Brigham and Women’s Hospital
Associate Professor of Psychiatry, Harvard Medical School

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