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2019-01-01
National Academies of Sciences, Engineering, and Medicine;
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already exist—like evidence-based medications—are not being deployed to maximum impact.
To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
2018-06-19
Carsey School of Public Policy at The University of New Hampshire;
Over the last two decades, opioid overdose deaths have increased over 400 percent, reaching 45,838 in 2016. Although the crisis is not disproportionately worse in rural than in urban America, opioid mortality rates have grown faster in rural areas, particularly in the Northeast and Midwest. Rural areas also face unique challenges in dealing with the crisis, including a smaller health care infrastructure than is available in more densely populated areas, community and family factors, and labor market stressors.
2018-06-05
Carsey School of Public Policy at The University of New Hampshire;
Hidden in the shadows of New Hampshire's opioid epidemic are the children who live with their parents' addiction every day. They fall behind in school as the trouble at home starts to dominate their lives, they make the 911 calls, they are shuttled about to live with relatives or in foster care, and they face an uncertain future when their parents can no longer care for them.
2018-05-11
FrameWorks Institute;
This communications toolkit provides advocates with clear, evidence-based guidance on how to shift public thinking about—and responses to—adolescent substance use.
2018-03-27
Carsey School of Public Policy at The University of New Hampshire;
The U.S. drug overdose problem has reached epidemic levels, prompting President Trump to declare a public health emergency. Since 2000, 786,781 people in the United States have died from drug overdoses and other drug-related causes, with nearly 40 percent of those deaths occurring in the last three years alone.
2017-12-19
Carsey School of Public Policy at The University of New Hampshire;
The opioid crisis besetting every region of the United States directly affects more than just those who use substances. For a pregnant woman, a consequence of substance use can be neonatal abstinence syndrome (NAS)—withdrawal symptoms experienced by the newborn.
2017-11-16
Altarum;
The negative impacts of the opioid epidemic are substantial and increasing rapidly over time. No part of society—including households, governments, and the private sector—is safe from the devastation brought on by this national crisis. The human toll of the combined misuse of prescription opioids, heroin, fentanyl, and related drugs has reached an unthinkable scale, with deaths soaring to more than 53,000 in 2016. Through this analysis of 2016 data, we estimate the magnitude of the economic and quantifiable societal harms and find the potential benefit of preventing opioid overdoses, deaths, and substance use disorders in 2016 would have exceeded $95 billion dollars—and preliminary data for 2017 predict this estimate will increase. This finding calls for substantial increases in funding at all levels—private and public sectors—to prevent opioid misuse and provide treatment for those affected.The potential benefits of eliminating the epidemic are concentrated in productivity gains from saved lives and reductions in substance use, averted health care costs due to fewer overdoses and other health complications, and lower spending on other services currently addressing the burden of opioids like law enforcement and child/family assistance (see Figure 1). These benefits—including savings to governments and increases in economic returns to households and the private sector (see Figure 2)—would accrue to all of society.
2017-10-25
Johns Hopkins Bloomberg School of Public Health;
The growing crisis of the U.S. opioid epidemic affects all of us, not just those caught in its grip. It is destroying lives, ripping families apart, weakening our communities, and preventing our country from taking full advantage of our greatest resource – our people. We ignore the problem at our peril. We can't afford to lose a single person. There is no single solution to this grave public health threat, but we know where to start. First, we must acknowledge that opioid addiction is a disease that requires comprehensive treatment. Closing the path to addiction means addressing the overprescription of legal opioids and the proliferation of illegal opioids such as heroin and drugs laced with fentanyl. We also have to build the public health response so that families, first responders, and community groups have the support necessary to turn the tide on the epidemic, and in the meantime don't have to bear an impossible economic and emotional burden. This report contains specific, proven recommendations for how to most effectively combat the epidemic – from allowing physicians to more effectively treat those suffering from addiction; to expanding coverage and accessibility of opioid overdose reversal drugs like naloxone; to changing the way that healthcare professionals, employers, and advocates talk about addiction to reduce stigma. These recommendations are a critical map for everyone working to fight the opioid crisis in America. We all have a part to play. At the Clinton Foundation, we have worked since 2012 to help prevent overdose deaths, increase awareness and understanding of the scale of the problem, and frame this as a public health issue. Moving forward, it's up to all of us – leaders from the advocacy, nonprofit, government, and business sectors – to act together. By prioritizing this issue and advancing these recommendations, we can prevent more lives from being lost to this epidemic and ensure a brighter future for all Americans.
2017-10-01
Conrad N. Hilton Foundation;
This Conrad N. Hilton Foundation report details a five-year strategy focused on developing and implementing substance use prevention and early intervention services for youth with three primary objectives for prevention and early intervention services: expand education and training; increase access and strengthen implementation; and develop and disseminate knowledge. The Year 3 report's recommendations are designed to galvanize the public, policy-makers, and healthcare systems to comprehensively address substance use at all levels of severity and the range of associated public health consequences.
2017-10-01
Open Society Foundations;
Methadone is one of the best-studied and most effective medication-assisted treatments for heroin dependence. Individuals and communities have found that methadone treatment not only reduces the use of opiates and the prevalence of overdose, but it also improves adherence to other medical regimens, increases employment, and improves family function. The systems that deliver methadone treatment programs, the conditions for their creation, expansion, and therapeutic success are just as important to understand as the treatment itself.
Globally Informed, Locally Responsive: Hong Kong's Common-Sense Approach to Expanding Methadone Treatment presents a model for how localities can review best practices from other treatment delivery contexts and then adapt these recommendations to their local needs, resource availability, political realities, and community expectations. It captures how Hong Kong sourced ideas from New York and other locales to construct a methadone program that serves the individuals and communities who are most in need.
Started in 1975, in response to a growing health and social crisis with an increasing number of opiate-dependent, heroin-injecting residents, the Hong Kong methadone program aims to make drug treatment accessible to all who need and want it through its 20 clinics around the territory. The program's success hinges on a number of features, including convenient hours and locations, robust staffing, and an understanding that abstinence should not be the only goal when supporting people with drug dependency.
The approach deployed in Hong Kong is pragmatic and flexible. Hong Kong conducted research and scaled up at the same time, prioritized making treatment widely available, and expedited enrollment. This approach has worked for decades to control heroin dependence and its negative consequences, such as HIV and Hepatitis C infection and crime, which have been common in other communities with heroin use.
Globally Informed, Locally Responsive offers an important insight for the design and provision of treatment services for people who use illicit drugs: the most effective systems are responsive to the needs of patients, not the other way around.
2017-10-01
Open Society Foundations;
Methadone is one of the best-studied and most effective medication-assisted treatments for heroin dependence. Individuals and communities have found that methadone treatment not only reduces the use of opiates and the prevalence of overdose, but it also improves adherence to other medical regimens, increases employment, and improves family function. The systems that deliver methadone treatment programs, the conditions for their creation, expansion, and therapeutic success are just as important to understand as the treatment itself.
Globally Informed, Locally Responsive: Hong Kong's Common-Sense Approach to Expanding Methadone Treatment presents a model for how localities can review best practices from other treatment delivery contexts and then adapt these recommendations to their local needs, resource availability, political realities, and community expectations. It captures how Hong Kong sourced ideas from New York and other locales to construct a methadone program that serves the individuals and communities who are most in need.
Started in 1975, in response to a growing health and social crisis with an increasing number of opiate-dependent, heroin-injecting residents, the Hong Kong methadone program aims to make drug treatment accessible to all who need and want it through its 20 clinics around the territory. The program's success hinges on a number of features, including convenient hours and locations, robust staffing, and an understanding that abstinence should not be the only goal when supporting people with drug dependency.
The approach deployed in Hong Kong is pragmatic and flexible. Hong Kong conducted research and scaled up at the same time, prioritized making treatment widely available, and expedited enrollment. This approach has worked for decades to control heroin dependence and its negative consequences, such as HIV and Hepatitis C infection and crime, which have been common in other communities with heroin use.
Globally Informed, Locally Responsive offers an important insight for the design and provision of treatment services for people who use illicit drugs: the most effective systems are responsive to the needs of patients, not the other way around.
2017-05-01
United Nations Office on Drugs and Crime (UNODC);
An estimated quarter of a billion people, or around 5 per cent of the global adult population, used drugs at least once in 2015. Even more worrisome is the fact that about 29.5 million of those drug users, or 0.6 per cent of the global adult population, suffer from drug use disorders. This means that their drug use is harmful to the point that they may experience drug dependence and require treatment.
The magnitude of the harm caused by drug use is underlined by the estimated 28 million years of "healthy" life (disability-adjusted life years (DALYs)) lost worldwide in 2015 as a result of premature death and disability caused by drug use.
Of those years lost, 17 million were attributable solely to drug use disorders across all drug types. DALYs attributable to morbidity and mortality resulting from all causes of drug use have increased overall in the past decade.
Yet, with fewer than one in six persons with drug use disorders provided with treatment each year, the availability of and access to science-based services for the treatment of drug use disorders and related conditions remain limited.
