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Review
. 2021 Jan;26(1):218-233.
doi: 10.1038/s41380-020-0661-4. Epub 2020 Feb 4.

The changing opioid crisis: development, challenges and opportunities

Nora D Volkow  1 , Carlos Blanco  2
Affiliations
Review

The changing opioid crisis: development, challenges and opportunities

Nora D Volkow et al. Mol Psychiatry. 2021 Jan.

Abstract

The current opioid epidemic is one of the most severe public health crisis in US history. Responding to it has been difficult due to its rapidly changing nature and the severity of its associated outcomes. This review examines the origin and evolution of the crisis, the pharmacological properties of opioids, the neurobiology of opioid use and opioid use disorder (OUD), medications for opioid use disorder (MOUD), and existing and promising approaches to prevention. The results of the review indicate that the opioid epidemic is a complex, evolving phenomenon that involves neurobiological vulnerabilities and social determinants of health. Successfully addressing the epidemic will require advances in basic science, development of more acceptable and effective treatments, and implementation of public health approaches, including prevention. The advances achieved in addressing the current crisis should also serve to advance the science and treatment of other substance use disorders.

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Conflict of interest statement

Conflict of Interest: The authors have no competing financial interests in relation to the work described in this manuscript.

Figures

Figure 1.
Figure 1.
The circuitry of opioid use disorder (reprinted with permission from: George O, Koob GF. Control of craving by the prefrontal cortex. Proc Natl Acad Sci U S A. 2013 Mar 12;110(11):4165-4166
See this image and copyright information in PMC

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MeSH terms

Substances