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The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction
Open accessAbstract
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.
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“Meanwhile, concerns continue to rise with regard to the risks of long-term, high-dose opioid use44 and dose escalation triggered by postsurgical opioid prescribing practices with little in the way of opioid tapering assistance.12”
From Acceptance and Commitment Therapy to manage pain and opioid use after major surgery: Preliminary outcomes from the Toronto General Hospital Transitional Pain Service (2017) · cites this paper as [44]
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Metadata
- Authors
- Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C.
- Affiliations
- Phoenix Houses of New England (US)
- University of North Florida (US)
- Johns Hopkins University (US)
- Brandeis University (US)
- Venue
- Annual Review of Public Health
- Publisher
- Annual Reviews
- Published
- 2015-03-18
- Volume
- 36
- Issue
- 1
- Pages
- 559-574
- ISSN
- 0163-7525 (ISSN-L)
- 1545-2093
- OpenAlex
- W2151383246
- Cited by
- 1,388
- References
- 82
- Citations by year
- 2026: 43 · 2025: 70 · 2024: 62 · 2023: 65 · 2022: 110 · 2021: 177 · 2020: 241 · 2019: 249 · 2018: 172 · 2017: 116 · 2016: 61 · 2015: 15
- FWCI
- 17.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Public Health (publishedVersion)
- PubMed (publishedVersion)
- 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 epidemic, opioid analgesics, heroin use, opioid use disorder, opioid overdose deaths, overprescribing, addiction prevention, addiction treatment, public health interventions
- MeSH terms
- Heroin Dependence, Humans, Opioid-Related Disorders, Primary Prevention, Public Health, United States, Secondary Prevention, Tertiary Prevention, Inappropriate Prescribing, Epidemics, Prescription Drug Misuse
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