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The changing opioid crisis: development, challenges and opportunities.
Nora D Volkow1, Carlos Blanco2
1National Institute on Drug Abuse, Bethesda, MD, 20892, USA. nvolkow@nida.nih.gov.
The opioid epidemic is a complex public health crisis driven by neurobiological factors and social determinants. Addressing it requires scientific advances, better treatments, and prevention strategies for opioid use disorder (OUD).
Area of Science:
- Public Health
- Neuroscience
- Pharmacology
Background:
- The US faces a severe opioid epidemic with significant public health consequences.
- The crisis is characterized by rapid evolution and severe outcomes, complicating response efforts.
Purpose of the Study:
- To review the origins and evolution of the opioid crisis.
- To examine the pharmacology and neurobiology of opioid use and opioid use disorder (OUD).
- To assess current and potential prevention and treatment strategies, including medications for opioid use disorder (MOUD).
Main Methods:
- Literature review of the opioid epidemic.
- Analysis of neurobiological mechanisms of opioid use disorder.
- Evaluation of pharmacological properties of opioids and MOUD.
Main Results:
- The opioid epidemic is a complex, evolving issue influenced by neurobiological vulnerabilities and social determinants of health.
- Current understanding highlights the interplay between individual susceptibility and societal factors in OUD.
- Existing MOUD and prevention approaches show promise but require further development.
Conclusions:
- Effective management of the opioid epidemic necessitates advancements in basic science and clinical treatments.
- Integrated public health approaches, including robust prevention programs, are crucial.
- Progress in combating the opioid crisis can inform strategies for other substance use disorders.
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