The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction

被引:1048
作者
Kolodny, Andrew [1 ,2 ,3 ]
Courtwright, David T. [4 ]
Hwang, Catherine S. [5 ,6 ]
Kreiner, Peter [1 ]
Eadie, John L. [1 ]
Clark, Thomas W. [1 ]
Alexander, G. Caleb [5 ,6 ,7 ]
机构
[1] Brandeis Univ, Heller Sch Social Policy & Management, Waltham, MA 02454 USA
[2] Phoenix House Fdn, New York, NY 10023 USA
[3] NYU, Global Inst Publ Hlth, New York, NY 10003 USA
[4] Univ N Florida, Dept Hist, Jacksonville, FL 32224 USA
[5] Johns Hopkins Univ, Ctr Drug Safety & Effectiveness, Baltimore, MD 21205 USA
[6] Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA
[7] Johns Hopkins Med, Div Gen Internal Med, Dept Med, Baltimore, MD 21205 USA
来源
ANNUAL REVIEW OF PUBLIC HEALTH, VOL 36 | 2015年 / 36卷
关键词
prescription drug abuse; heroin; overdose deaths; chronic pain; opioid; addiction; NEONATAL ABSTINENCE SYNDROME; INJECTION-DRUG USERS; HIGH-DOSE METHADONE; UNITED-STATES; NONMALIGNANT PAIN; OVERDOSE DEATHS; ADVERSE EVENTS; NONMEDICAL USE; BUPRENORPHINE; DEPENDENCE;
D O I
10.1146/annurev-publhealth-031914-122957
中图分类号
R1 [预防医学、卫生学];
学科分类号
100235 [预防医学];
摘要
Public health authorities have described, with growing alarm, an unprecedented increase in morbidity and mortality associated with use of opioid pain relievers (OPRs). Efforts to address the opioid crisis have focused mainly on reducing nonmedical OPR use. Too often overlooked, however, is the need for preventing and treating opioid addiction, which occurs in both medical and nonmedical OPR users. Overprescribing of OPRs has led to a sharp increase in the prevalence of opioid addiction, which in turn has been associated with a rise in overdose deaths and heroin use. A multifaceted public health approach that utilizes primary, secondary, and tertiary opioid addiction prevention strategies is required to effectively reduce opioid-related morbidity and mortality. We describe the scope of this public health crisis, its historical context, contributing factors, and lines of evidence indicating the role of addiction in exacerbating morbidity and mortality, and we provide a framework for interventions to address the epidemic of opioid addiction.
引用
收藏
页码:559 / 574
页数:16
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