Management of opioid use disorder in the USA: present status and future directions
Abstract
Opioid use disorder is characterised by the persistent use of opioids despite the adverse consequences of its use. The disorder is associated with a range of mental and general medical comorbid disorders, and with increased mortality. Although genetics are important in opioid use disorder, younger age, male sex, and lower educational attainment level and income, increase the risk of opioid use disorder, as do certain psychiatric disorders (eg, other substance use disorders and mood disorders). The medications for opioid use disorder, which include methadone, buprenorphine, and extended-release naltrexone, significantly improve opioid use disorder outcomes. However, the effectiveness of medications for opioid use disorder is limited by problems at all levels of the care cascade, including diagnosis, entry into treatment, and retention in treatment. There is an urgent need for expanding the use of medications for opioid use disorder, including training of health-care professionals in the treatment and prevention of opioid use disorder, and for development of alternative medications and new models of care to expand capabilities for personalised interventions.
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There are brief self-report instruments with high sensitivity and good specificity available for use in general health settings.
“There are brief self- report instruments with high sensitivity and good specificity 146 available for use in general health settings.”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [146]
Because individuals with SUDs are likely to seek treatment for other conditions such as infections or pain, screening for substance misuse in psychiatric and general medical settings is an effective way to identify SUDs.
“Since these individuals are likely to seek treatment for other conditions, such as infections or pain, screening for substance misuse in psy chiatric and general medical settings is an effective way to identify SUDs 146,147 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [146]
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- Authors
- Blanco, C., & Volkow, N. D.
- Affiliations
- National Institute on Drug Abuse (US)
- Corresponding author
- Blanco, Carlos
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 393
- Issue
- 10182
- Pages
- 1760-1772
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2921255665
- Cited by
- 407
- References
- 17
- Citations by year
- 2026: 34 · 2025: 57 · 2024: 44 · 2023: 69 · 2022: 66 · 2021: 66 · 2020: 57 · 2019: 13
- FWCI
- 8.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- opioid use disorder, medication-assisted treatment, methadone, buprenorphine, extended-release naltrexone, cascade of care, treatment retention, treatment entry, risk factors, psychiatric comorbidity, health professions education, models of care, personalized interventions
- MeSH terms
- Adult, Analgesics, Opioid, Delivery of Health Care, Female, Forecasting, Humans, Male, Opioid-Related Disorders, Narcotics, Patient Acceptance of Health Care, Risk Factors, Substance Withdrawal Syndrome, United States, Prevalence, Early Diagnosis, Drug Overdose
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