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Review
. 2022 Nov;23(16):1819-1830.
doi: 10.1080/14656566.2022.2140039. Epub 2022 Nov 14.

Current and emerging pharmacotherapies for opioid dependence treatments in adults: a comprehensive update

Jonna M Leyrer-Jackson  1 , Amanda M Acuña  2   3 , M Foster Olive  2   3
Affiliations
Review

Current and emerging pharmacotherapies for opioid dependence treatments in adults: a comprehensive update

Jonna M Leyrer-Jackson et al. Expert Opin Pharmacother. 2022 Nov.

Abstract

Introduction: Opioid use disorder (OUD) is characterized by compulsive opioid seeking and taking, intense drug craving, and intake of opioids despite negative consequences. The prevalence of OUDs has now reached an all-time high, in parallel with peak rates of fatal opioid-related overdoses, where 15 million individuals worldwide meet the criteria for OUD. Further, in 2020, 120,000 opioid-related deaths were reported worldwide with over 75,000 of those deaths occurring within the United States.

Areas covered: In this review, we highlight pharmacotherapies utilized in patients with OUDs, including opioid replacement therapies, and opioid antagonists utilized for opioid overdoses and deterrent of opioid use. We also highlight newer treatments, such as those targeting the neuroimmune system, which are potential new directions for research given the recently established role of opioids in activating neuroinflammatory pathways, as well as over the counter remedies, including kratom, that may mitigate withdrawal.

Expert opinion: To effectively treat OUDs, a deeper understanding of the current therapeutics being utilized, their additive effects, and the added involvement of the neuroimmune system are essential. Additionally, a complete understanding of opioid-induced neuronal alterations and therapeutics that target these abnormalities - including the neuroimmune system - is required to develop effective treatments for OUDs.

Keywords: Opioids; buprenorphine; kratom; levo-alpha-acetyl-methadol; methadone; naloxone; naltrexone; opioid use disorder; pharmacotherapies.

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Conflict of interest statement

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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