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The Deepening Opioid Crisis in North America: Historical Context and Current Solutions

Current Addiction Reports volume 5, pages 454–463 (2018)Cite this article

Abstract

Purpose of Review

The purpose of this review is to (1) detail the historical context behind the rise of opioid use disorder (OUD) and opioid-related harms in the United States (US) and Canada, (2) describe the epidemiology of OUD in these two countries, and (3) discuss current strategies being employed to address this public health emergency in North America.

Recent Findings

Opioid-related overdose has become a leading cause of unintentional injury related death in North America. Deaths have risen in parallel with opioid prescribing and the rising prevalence of unintentional exposure to highly potent synthetic opioids. At the same time, rates of injection drug use-related infections such as hepatitis C and endocarditis have also increased.

Summary

Both Canada and the US have implemented policy changes and interventions at the national and local levels in an attempt to stem rising opioid attributable morbidity and mortality. In many settings, the collective goal has been to increase access to treatment of OUD, expand harm reduction interventions (including improved access to naloxone), and develop and disseminate guidelines on the safe prescribing of opioids for non-cancer pain and the management of OUD.

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Acknowledgements

M. Eugenia Socias is supported by a Michael Smith Foundation for Health Research (MSFHR)/St Paul’s Foundation Scholar Award.

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Authors and Affiliations

  1. Department of Internal Medicine, Yale University School of Medicine, 367 Cedar Street, Suite 305, New Haven, CT, 06510, USA

    Joseph H. Donroe

  2. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada

    M. Eugenia Socias

  3. Department of Medicine, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    M. Eugenia Socias

  4. Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI, 02912, USA

    Brandon D. L. Marshall

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Correspondence to Joseph H. Donroe.

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Donroe, J.H., Socias, M.E. & Marshall, B.D.L. The Deepening Opioid Crisis in North America: Historical Context and Current Solutions. Curr Addict Rep 5, 454–463 (2018). https://doi.org/10.1007/s40429-018-0228-5

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Keywords

  • Opioid
  • Addiction
  • Overdose
  • North America
  • Fentanyl
  • Heroin