Prevalent Misconceptions About Opioid Use Disorders in the United States Produce Failed Policy and Public Health Responses. (17th November 2018)

• Record Type: Journal Article
• Authors: Heimer, Robert; Hawk, Kathryn; Vermund, Sten H
• Is Part Of: Clinical infectious diseases. Volume 69:Number 3(2019)
• Page Start: 546
• Page End: 551
• Publication Date: 2018-11-17
• Subjects: opioids -- overdose -- pain -- injection drug use; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciy977
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: The current opioid crisis in the United States has emerged from higher demand for and prescribing of opioids as chronic pain medication, leading to massive diversion into illicit markets. A peculiar tragedy is that many health professionals prescribed opioids in a misguided response to legitimate concerns that pain was undertreated. The crisis grew not only from overprescribing, but also from other sources, including insufficient research into nonopioid pain management, ethical lapses in corporate marketing, historical stigmas directed against people who use drugs, and failures to deploy evidence-based therapies for opioid addiction and to comprehend the limitations of supply-side regulatory approaches. Restricting opioid prescribing perversely accelerated narco-trafficking of heroin and fentanyl with consequent increases in opioid overdose mortality As injection replaced oral consumption, outbreaks of hepatitis B and C virus and human immunodeficiency virus infections have resulted. This viewpoint explores the origins of the crisis and directions needed for effective mitigation. Abstract : The current crisis of illicit opioid use and overdose has its roots in 2 prior epidemics, misconceptions about treatment of chronic pain, and stigma against drug users. Correcting historical inaccuracies and addressing stigma are key to amelioration of the crisis.