How Should the United States Respond to the Opioid Addiction and Overdose Epidemic?

  • Keith Humphreys
  • Harold A. Pollack


The national epidemic of addiction to and overdose from opioids is the worst public health crisis the United States has faced in decades. The health care system is critical to the public policy response, both because of the services it can provide people with opioid use disorder and the changes in clinical practice it must make to prevent new cases of addiction. For historical and cultural reasons, health services for people with opioid use disorder are often of uneven quality and poorly integrated with the rest of health care. However, effective services are available that can make a major contribution to pushing back against the epidemic. These include opioid agonist therapies (e.g., buprenorphine maintenance), antagonist therapies (e.g., extended-release naltrexone), and psychosocial treatments. Interventions that reduce the mortality and morbidity risks of opioids, such as syringe exchange and naloxone provision, are also critical to an effective public health response. Supply-side policies within the US health care system are also essential because overprescribing is at an extraordinarily high level both historically and currently in comparison to other nations. A range of monitoring, educational, and incentive-based interventions show promise of returning the United States to a more rational prescribing pattern.


  1. 1.
    Ruhm, C. J. (2018). Corrected US opioid-involved drug poisoning deaths and mortality rates, 1999–2015. Addiction, 113, 1339–1344.CrossRefGoogle Scholar
  2. 2.
    Katz, J. (2017, September 2). The first count of fentanyl deaths in 2016: Up 540% in three years. New York Times.
  3. 3.
    Humphreys, K., Caulkins, J., & Felbab-Brown, V. (2018). Opioids of the masses: Stopping an American epidemic from going global. Foreign Affairs, 97, 118–129.Google Scholar
  4. 4.
    Buck, J. A. (2011). The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act. Health Affairs, 20, 1402–1410.CrossRefGoogle Scholar
  5. 5.
    Carson, E. A., & Anderson, E. (2016). Prisoners in 2015. Bureau of Justice Statistics Bulletin. United States Department of Justice.Google Scholar
  6. 6.
    Patashnik, E. M., Gerber, A. A., & Dowling, C. M. (2017). Unhealthy politics: The battle over evidence-based medicine. Princeton: Princeton University Press.CrossRefGoogle Scholar
  7. 7.
    White, W. L. (1998). Slaying the dragon: The history of addiction treatment and recovery in America. Bloomington, IL: Chestnut Health Systems.Google Scholar
  8. 8.
    Humphreys, K. (2004). Circles of recovery: Self-help organisations for addictions. Cambridge, UK: Cambridge University Press.Google Scholar
  9. 9.
    Humphreys, K. (2017). How to deliver a more persuasive message regarding addiction as a medical disorder. Journal of Addiction Medicine, 11, 174–175.CrossRefGoogle Scholar
  10. 10.
    Humphreys, K., & Piot, P. (2012). Scientific evidence alone is not sufficient basis for health policy. British Medical Journal, 344, e1316.CrossRefGoogle Scholar
  11. 11.
    Forman, J. J. (2017). Locking up our own: Crime and punishment in Black America. New York: Macmillan.Google Scholar
  12. 12.
    Massing, M. (2000). The fix. Berkeley: University of California Press.Google Scholar
  13. 13.
    Babor, T. F., Caulkins, J., Fischer, B., Foxcroft, D., Humphreys, K., Medina-Mora, M., … Strang, J. S. (2018). Drug policy and the public good (2nd ed.). London: Oxford University Press.Google Scholar
  14. 14.
    Dagan, D., & Teles, S. (2016). Prison break why conservatives turned against mass incarceration. Oxford: Oxford University Press.Google Scholar
  15. 15.
    Gottlieb, S. (2017). Remarks from FDA Commissioner Scott Gottlieb, M. D., as prepared for oral testimony before the House Committee on Energy and Commerce Hearing, “Federal Efforts to Combat the Opioid Crisis: A Status Update on CARA and Other Initiatives”.
  16. 16.
    Kaplan, S. (2018, February 25). F.D.A. to expand medication-assisted therapy for opioid addicts. New York Times.
  17. 17.
    Waxman, O. (2017, October 26). As President Trump declares opioid emergency, here’s what to know about the history of ‘Just Say No’. Time.
  18. 18.
    Phillips, K. (2018, February 27). Trump reportedly praised Singapore for executing drug dealers. Here’s how they’re killed. Washington Post.
  19. 19.
    Lopez, G. (2017, October 24). Under Trump and Sessions, federal prosecutors are ramping up the war on drugs.
  20. 20.
    Darke, S., & Zador, D. (1996). Fatal heroin “overdose”: A review. Addiction, 91, 1765–1772.CrossRefGoogle Scholar
  21. 21.
    Sun, E. C., Dixit, A., Humphreys, K., Darnell, B., Baker, L. C., & Mackey, S. (2017). Association between concurrent use of prescription opioids and benzodiazepine with overdose: A retrospective analysis. British Medical Journal, 356, j760.CrossRefGoogle Scholar
  22. 22.
    Hall, W. D., & Strang, J. S. (2017). Alcohol problems need more attention in patients receiving long-term opioid substitution therapy. Lancet Psychiatry, 4, 265–266.CrossRefGoogle Scholar
  23. 23.
    McLellan, A. T., Luborsky, L., Woody, G. E., O’Brien, C. P., & Kron, R. (1981). Are the “addiction-related” problems of substance abusers really related? Journal of Nervous and Mental Disease, 169, 232–239.CrossRefGoogle Scholar
  24. 24.
    Mbaba, M., Brown, S. E., Wooditch, A., Kiss, M., Murphy, A., Kumari, S., … Springer, S. A. (2018). Prevalence, diagnosis, and treatment rates of mood disorders among opioid users under criminal justice supervision. Substance Use & Misuse, 53, 1519–1528.Google Scholar
  25. 25.
    Humphreys, K., Malenka, R., Knutson, B., & MacCoun, R. (2017). Brains, environments and policy responses to addiction. Science, 356, 1237–1238.CrossRefGoogle Scholar
  26. 26.
    Allen, B. (2015, August 16). When rehab might help an addict—But insurance won’t cover it. National Public Radio.
  27. 27.
    Strang, J., McCambridge, J., Best, D., Beswick, T., Bearn, J., Rees, S., & Gossop, M. (2003). Loss of tolerance and overdose mortality after inpatient opiate detoxification: Follow up study. British Medical Journal, 326, 959–960.Google Scholar
  28. 28.
    Binswanger, I. A., Stern, M. F., Deyo, R. A., Heagerty, P. J., Cheadle, A., Elmore, J. G., & Koepsell, T. D. (2007). Release from prison—A high risk of death for former inmates. New England Journal of Medicine, 356, 157–165.Google Scholar
  29. 29.
    Herman, D. B., & Mandiberg, J. M. (2010). Critical time intervention: Model description and implications for the significance of timing in social work interventions. Research on Social Work Practice, 20, 502–508.CrossRefGoogle Scholar
  30. 30.
    Green, T. C., Clarke, J., Brinkley-Rubinstein, L., Marshall, B. D. L., Alexander-Scott, N., Boss, R., & Rich, J. D. (2018, February 14). Post incarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. JAMA Psychiatry.
  31. 31.
    Carroll, K. M., & Weiss, R. D. (2017). The role of behavioral interventions in buprenorphine maintenance treatment: A review. American Journal of Psychiatry, 174, 738–747.CrossRefGoogle Scholar
  32. 32.
    Richardson, L., Wood, E., Li, K., & Kerr, T. (2010). Factors associated with employment among a cohort of injection drug users. Drug and Alcohol Review, 29, 293–300.CrossRefGoogle Scholar
  33. 33.
    Fiellin, D. A., Kleber, H., Trumble-Hejduk, J. G., McLellan, A. T., & Kosten, T. R. (2004). Consensus statement on office-based treatment of opioid dependence using buprenorphine. Journal of Substance Abuse Treatment, 27(2), 153–159.CrossRefGoogle Scholar
  34. 34.
    Alderks, C. (2017). Trends in the use of methadone, buprenorphine, and extended-release naltrexone at substance abuse treatment facilities 2003–2015 (updated) (CBHSQ Report). Accessed December 20, 2017.
  35. 35.
    Clemens-Cope, L. Epstein, M., & Kenney, G. M. (2017). Rapid growth in Medicaid spending on medications to treat opioid use disorder and overdose. Washington, DC: Urban Institute.
  36. 36.
    World Health Organization. (2009). WHO guidelines for psychosocially assisted pharmacological treatment of persons dependent on opioids. Geneva, Switzerland: World Health Organization.Google Scholar
  37. 37.
    Amato, L., Davoli, M., Perucci, C. A., Ferri, M., Faggiano, F., & Mattick, R. (2005). An overview of systematic reviews of the effectiveness of opiate maintenance therapies: Available evidence to inform clinical practice and research. Journal of Substance Abuse Treatment, 28, 321–330.CrossRefGoogle Scholar
  38. 38.
    Barnett, P. (1999). The cost-effectiveness of methadone maintenance as a health care intervention. Addiction, 94, 479–488.CrossRefGoogle Scholar
  39. 39.
    Gunne, L. M., & Grönbladh, L. (1981). The Swedish methadone maintenance program: A controlled study. Drug and Alcohol Dependence, 7, 249–256.CrossRefGoogle Scholar
  40. 40.
    Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L., … Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. British Medical Journal, 357, j1550.Google Scholar
  41. 41.
    Basu, A., Paltiel, A. D., & Pollack, H. A. (2008). Social costs of robbery and the cost-effectiveness of substance abuse treatment. Health Economics, 17, 927–946.CrossRefGoogle Scholar
  42. 42.
    Adi, Y., Juarez-Garcia, A., Wang, D., Jowett, S., Frew, E., Day, E., … Burls, A. (2007). Oral naltrexone as a treatment for relapse prevention in formerly opioid-dependent drug users: A systematic review and economic evaluation. Health Technology Assessment, 11, 1–85.Google Scholar
  43. 43.
    Connery, H. S. (2015). Medication-assisted treatment of opioid use disorder: Review of the evidence and future directions. Harvard Review of Psychiatry, 23, 63–75.CrossRefGoogle Scholar
  44. 44.
    Krupitsky, E., Zvartau, E., Blokhina, E., Verbitskaya, E., Wahlgren, V., Tsoy-Podosenin, M., … Woody, G. E. (2012). Randomized trial of long-acting sustained-release naltrexone implant vs oral naltrexone or placebo for preventing relapse to opioid dependence. Archives of General Psychiatry, 69, 973–981.Google Scholar
  45. 45.
    Lee, J. D., Friedmann, P. D., Kinlock, T. W., Nunes, E. V., Boney, T. Y., Hoskinson, R. A., … O’Brien, C. P. (2016). Extended-release naltrexone to prevent opioid relapse in criminal justice offenders. New England Journal of Medicine, 374, 1232–1242.Google Scholar
  46. 46.
    Tanum, L., Solli, K. K., Latif, Z., Benth, J. S., Opheim, A., Sharma-Haase, K., … Kune, N. (2017). Effectiveness of injectable extended-release naltrexone vs daily buprenorphine-naloxone for opioid dependence. JAMA Psychiatry, 74, 1197–1205.Google Scholar
  47. 47.
    Prendergast, M. L., Podus, D., Chang, E., & Urada, D. (2002). The effectiveness of drug abuse treatment: A meta-analysis of comparison group studies. Drug and Alcohol Dependence, 67, 53–73.CrossRefGoogle Scholar
  48. 48.
    Mayet, S., Farrell, M., Ferri, M., Amato, L., & Davoli, M. (2005, January 25). Psychosocial treatment for opiate abuse and dependence. Cochrane Database Systematic Review, 1, CD004330.Google Scholar
  49. 49.
    Butzin, C. A., Martin, S. S., & Inciardi, J. A. (2005). Treatment during transition from prison to community and subsequent illicit drug use. Journal of Substance Abuse Treatment, 28, 351–358.CrossRefGoogle Scholar
  50. 50.
    Vanderplasschen, W., Colpaert, K., Autrique, M., Rapp, R., Pearce, A., Broekaert, E., & Vandevelde, S. (2013, January 15). Therapeutic communities for addictions: A review of their effectiveness from a recovery-oriented perspective. Scientific World Journal, 2013, 1–22.Google Scholar
  51. 51.
    Babor, T. F., Caulkins, J., Edwards, G. E., Fischer, B., Foxcroft, D., Humphreys, K., … Strang, J. S. (2010). Drug policy and the public good. New York: Oxford University Press.Google Scholar
  52. 52.
    Welsh, W. N., Zajac, G., & Bucklen, K. B. (2014). For whom does prison-based drug treatment work? Results from a randomized experiment. Journal of Experimental Criminology, 10, 151–177.CrossRefGoogle Scholar
  53. 53.
    D’Aunno, T., & Pollack, H. A. (2002). Changes in methadone treatment practices: Results from a national panel study, 1988–2000. Journal of the American Medical Association, 288, 850–856.CrossRefGoogle Scholar
  54. 54.
    White, W., Galanter, M., Humphreys, K., & Kelly, J. (2016). The paucity of attention to Narcotics Anonymous in current public, professional and policy responses to rising opioid addiction. Alcoholism Treatment Quarterly, 34, 437–462.CrossRefGoogle Scholar
  55. 55.
    Jason, L. A., Olson, B. D., Ferrari, J. R., & Lo Sasso, L. T. (2006). Communal housing settings enhance substance abuse recovery. American Journal of Public Health, 96, 1727–1729.CrossRefGoogle Scholar
  56. 56.
    Heimer, R. (1998). Can syringe exchange serve as a conduit to substance abuse treatment? Journal of Substance Abuse Treatment, 15, 183–191.CrossRefGoogle Scholar
  57. 57.
    Pollack, H. A. (2001). Cost-effectiveness of harm reduction in preventing Hepatitis C among injection drug users. Medical Decision Making, 21, 357–367.CrossRefGoogle Scholar
  58. 58.
    Groseclose, S. L., Weinstein, B., Jones, T. S., Valleroy, L. A., Fehrs, L. J., & Kassler, W. (1995). Impact of increased legal access to needles and syringes on practices of injecting-drug users and police officer, Connecticut, 1992–1993. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 10, 82–89.CrossRefGoogle Scholar
  59. 59.
    Humphreys, K. (2015). An overdose rescue drug goes mainstream. Health Affairs, 34, 1624–1627.CrossRefGoogle Scholar
  60. 60.
    Baca, C. T., & Grant, K. J. (2005). Take-home naloxone to reduce heroin death. Addiction, 100, 1823–1831.CrossRefGoogle Scholar
  61. 61.
    Strang, J., Darke, S., Hall, W., Farrell, M., & Ali, R. (1996). Heroin overdose: The case for take-home naloxone. British Medical Journal, 312, 1435–1436.CrossRefGoogle Scholar
  62. 62.
    Darke, S., & Hall, W. (1997). The distribution of naloxone to heroin users. Addiction, 92, 1195–1199.CrossRefGoogle Scholar
  63. 63.
    McDonald, R., & Strang, J. S. (2016). Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria. Addiction, 111, 1177–1187.CrossRefGoogle Scholar
  64. 64.
    Walley, A. Y., Xuan, Z., Hackman, H. H., et al. (2013). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: Interrupted time series analysis. British Medical Journal, 346, f174.Google Scholar
  65. 65.
    Williams, A. V., Marsden, J., & Strang, J. (2014). Training family members to manage heroin overdose and administer naloxone: Randomized trial of effects on knowledge and attitudes. Addiction, 109, 250–259.CrossRefGoogle Scholar
  66. 66.
    Bashir, K., King, M., & Ashworth, M. (1994). Controlled evaluation of brief intervention by general practitioners to reduce chronic use of benzodiazepines. British Journal of General Practice, 44, 408–412.Google Scholar
  67. 67.
    Cormack, M. A., Sweeney, K. G., Hughes-Jones, H., & Foot, G. A. (1994). Evaluation of an easy, cost-effective strategy for cutting benzodiazepine use in general practice. British Journal of General Practice, 44, 5–8.Google Scholar
  68. 68.
    Tannenbaum, C., Martin, P., & Tamblin, R. (2014). Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: The EMPOWER cluster randomized trial. JAMA Internal Medicine, 174, 890–898.CrossRefGoogle Scholar
  69. 69.
    Marsden, J., Stillwell, G., Barlow, H., Boys, A., Taylor, C., Hunt, N., & Farrell, M. (2005). An evaluation of a brief motivational intervention among young ecstasy and cocaine users: No effect on substance and alcohol use outcomes. Addiction, 101, 1014–1026.Google Scholar
  70. 70.
    Baker, A., Lewin, T., Reichler, H., Clancy, R., Carr, V., Garrett, R., … Terry, M. (2002). Evaluation of a motivational interview for substance use within psychiatric in-patient services. Addiction, 97, 1329–1337.Google Scholar
  71. 71.
    Humphreys, K. (2017). Avoiding globalisation of the prescription opioid epidemic. The Lancet, 390, 437–439.CrossRefGoogle Scholar
  72. 72.
    Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain—United States. Morbidity and Mortality Weekly Report, 65, 1–49.Google Scholar
  73. 73.
    Lembke, A., Humphreys, K., & Newmark, J. (2016). Weighing the risks and benefits of chronic opioid therapy. American Family Physician, 93, 982–990.Google Scholar
  74. 74.
    Morris, L. A., & Halperin, J. A. (1979). Effects of written drug information on patient knowledge and compliance: A literature review. American Journal of Public Health, 69, 47–52.CrossRefGoogle Scholar
  75. 75.
    Peveler, R., George, C., Kinmonth, A. L., Campbell, M., & Thompson, C. (1999). Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: Randomised controlled trial. British Medical Journal (Clinical Research Ed.), 319, 612–615.CrossRefGoogle Scholar
  76. 76.
    Roughead, E. E., Semple, S. J., & Vitry, A. I. (2005). Pharmaceutical care services: A systematic review of published studies, 1990 to 2003, examining effectiveness in improving patient outcomes. International Journal of Pharmacy Practice, 13, 53–70.CrossRefGoogle Scholar
  77. 77.
    Schnipper, J. L., Kirwin, J. L., Cotugno, M. C., Wahlstrom, S. A., Brown, B. A., Tarvin, E., … Bates, D. W. (2006). Role of pharmacist counseling in preventing adverse drug events after hospitalization. Archives of Internal Medicine, 166, 565–571.Google Scholar
  78. 78.
    Christensen, D. B., & Farris, K. B. (2006). Pharmaceutical care in community pharmacies: Practice and research in the US. The Annals of Pharmacotherapy, 40, 1400–1406.CrossRefGoogle Scholar
  79. 79.
    Betses, M., & Brennan, T. (2013). Abusive prescribing of controlled substances—A pharmacy view. New England Journal of Medicine, 369, 989–991.CrossRefGoogle Scholar
  80. 80.
    Sacarny, A., Yokum, D., Finkelstein, A., & Agrawal, S. (2016). Medicare letters to curb overprescribing of controlled substances had no detectable effect on providers. Health Affairs, 35, 471–479.CrossRefGoogle Scholar
  81. 81.
    Aaserud, M., Dahlgren, A. T., Kosters, J. P., Oxman, A. D., Ramsay, C., & Sturm, H. (2006). Pharmaceutical policies: Effects of reference pricing, other pricing, and purchasing policies. The Cochrane Database of Systematic Reviews, 2, CD005979.Google Scholar
  82. 82.
    Cicero, T. J., Inciardi, J. A., Adams, E. H., Geller, A., Senay, E. C., Woody, G. E., & Munoz, A. (2005). Rates of abuse of tramadol remain unchanged with the introduction of new branded and generic products: Results of an abuse monitoring system, 1994–2004. Pharmacoepidemiology and Drug Safety, 14, 851–859.Google Scholar
  83. 83.
    Gomes, T., Mamdani, M. M., Dhalla, I. A., Cornish, S., Paterson, J. M., & Juurlink, D. N. (2014). The burden of premature opioid-related mortality. Addiction, 109, 1482–1488.CrossRefGoogle Scholar
  84. 84.
    Fischer, B., & Keates, A. (2012). ‘Opioid drought’, Canadian-style? Potential implications of the ‘natural experiment’ of delisting Oxycontin in Canada. The International Journal on Drug Policy, 23, 495–497.CrossRefGoogle Scholar
  85. 85.
    Fischer, B., Jones, W., & Rehm, J. (2014). Trends and changes in prescription opioid analgesic dispensing in Canada 2005–2012: An update with a focus on recent interventions. BMC Health Services Research, 14, 90.CrossRefGoogle Scholar
  86. 86.
    Faul, M., Bohm, M., & Alexander, C. (2017). Methadone prescribing and overdose an the association with Medicaid preferred drug list policies—United States, 2007–2014. Morbidity and Mortality Weekly Report, 66, 320–323.CrossRefGoogle Scholar
  87. 87.
    Hall, A. J., Logan, J. E., Toblin, R. L., Kaplan, J. A., Kraner, J. C., Bixler, D., … Paulozzi, L. J. (2008). Patterns of abuse among unintentional pharmaceutical overdose fatalities. Journal American Medical Association, 300, 2613–2620.Google Scholar
  88. 88.
    Roberts, A. W., & Skinner, A. C. (2014). Assessing the present state and potential of Medicaid controlled substance lock-in programs. Journal of Managed Care & Specialty Pharmacy, 20(5), 439–446.CrossRefGoogle Scholar
  89. 89.
    Katz, N. P., Brennan, M. J., Freedman, J. D., Birnbaum, H., Gilmore, G. P., Jay, D., … White, A. G. (2013). Prescription opioid abuse: Challenges and opportunities for payers. American Journal of Managed Care, 19, 295–302.Google Scholar
  90. 90.
    Franklin, G., Sabel, S., Jones, C. M., Mai, J., Baumgartner, C., Banta-Green, C. J., … Tauben, D. J. (2015). A comprehensive approach to address the prescription opioid epidemic in Washington State: Milestones and lessons learned. American Journal of Public Health, 105, 463–469.Google Scholar
  91. 91.
    Brennan, N., & Mattick, K. (2013). A systematic review of educational interventions to change behaviour of prescribers in hospital settings, with a particular emphasis on new prescribers. British Journal of Clinical Pharmacology, 75, 359–372.CrossRefGoogle Scholar
  92. 92.
    Franklin, G. M., Mai, J., Turner, J., Sullivan, M., Wickizer, T., & Fulton-Kehoe, D. (2012). Bending the prescription opioid dosing and mortality curves: Impact of the Washington state opioid dosing guideline. American Journal of Industrial Medicine, 55, 325–331.CrossRefGoogle Scholar
  93. 93.
    Pimlott, N. J., Hux, J. E., Wilson, L. M., Kahan, M., Li, C., & Rosser, W. W. (2003). Educating physicians to reduce benzodiazepine use by elderly patients: A randomized controlled trial. CMAJ: Canadian Medical Association Journal [Journal De L’Association Medicale Canadienne], 168, 835–839.Google Scholar
  94. 94.
    Hooper, S., Bruno, R., Sharpe, M., & Tahmindjis, A. (2009). Alprazolam prescribing in tasmania: A two-fold intervention designed to reduce inappropriate prescribing and concomitant opiate prescription. Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists, 17, 300–305.CrossRefGoogle Scholar
  95. 95.
    Kahan, M., Gomes, T., Juurlink, D. N., Manno, M., Wilson, L., Mailis-Gagnon, A., … Mamdani, M. M. (2013). Effect of a course-based intervention and effect of medical regulation on physicians’ opioid prescribing. Canadian Family Physician, 59, 231–239.Google Scholar
  96. 96.
    Parish, C. L., Pereyra, M. R., Pollack, H. A., Cardenas, G., Castellon, P. C., Abel, S. N., … Metsch, L. R. (2015). Screening for substance misuse in the dental care setting: Findings from a nationally representative survey of dentists. Addiction, 110, 1516–1523.Google Scholar
  97. 97.
    Saunders, K., Shortreed, S., Thielke, S., Turner, J. A., LeResche, L., Beck, R., & Von Korff, M. (2015). Evaluation of health plan interventions to influence chronic opioid therapy prescribing. Clinical Journal of Pain.
  98. 98.
    Victorri-Vigneau, C., Basset, G., Bourin, M., & Jolliet, P. (2003). Impacts of the new flunitrazepam regulations on the consumption of hypnotics [Impacts de la nouvelle reglementation du flunitrazepam sur la consommation d’hypnotiques]. Therapie, 58(5), 425–430.Google Scholar
  99. 99.
    Jonasson, U., & Jonasson, B. (2004). Restrictions on the prescribing of dextropropoxyphene (DXP)-effects on sales and cases of fatal poisoning. Stockholm, Sweden: Swedish National Board of Forensic Medicine and Medical Products Agency.Google Scholar
  100. 100.
    Seago, S., Hayek, A., Pruszynski, J., & Newman, M. G. (2016). Change in prescription habits after federal rescheduling of hydrocodone combination products. Baylor University Medical Center Proceedings, 29, 268–270.CrossRefGoogle Scholar
  101. 101.
    Jones, C. M., Lurie, P. G., & Throckmorton, D. C. (2016). Effect of US Drug Enforcement Administration’s rescheduling of hydrocodone combination analgesic products on opioid analgesic prescribing. JAMA Internal Medicine, 176, 399–402.CrossRefGoogle Scholar
  102. 102.
    Furlan, A. D., MacDougall, P., Pellerin, D., Shaw, K., Spitzig, D., Wilson, G., & Wright, J. (2014). Overview of four prescription monitoring/review programs in Canada. Pain Research & Management, 19, 102–106.Google Scholar
  103. 103.
    Katz, N., Houle, B., Fernandez, K., Kreiner, P., Thomas, C., Kim, M., … Brushwood, D. (2008). Update on prescription monitoring in clinical practice: A survey study of prescription monitoring program administrators. Pain Medicine, 9, 587–594.Google Scholar
  104. 104.
    Pardo, B. (2017). Do more robust prescription drug monitoring programs reduce prescription opioid overdose? Addiction, 112, 1773–1783.CrossRefGoogle Scholar
  105. 105.
    Moyo, P., Simoni-Wastila, L., Griffi, B. A., Harrington, D., Alexander, G. C., & Palumbo, F. (2017). Impact of prescription drug monitoring programs (PDMPs) on opioid utilization among Medicare beneficiaries in 10 U.S. States. Addiction, 112, 1784–1796.CrossRefGoogle Scholar
  106. 106.
    Baehren, D. F., Marco, C. A., Droz, D. E., Sinha, S., Callan, E. M., & Akpunonu, P. (2010). A statewide prescription monitoring program affects emergency department prescribing behaviors. Annals of Emergency Medicine, 56, 19–23.CrossRefGoogle Scholar
  107. 107.
    Dormuth, C. R., Miller, T. A., Huang, A., Mamdani, M. M., & Juurlink, D. N. (2012). Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines. Canadian Medical Association Journal, 184, E852–E856.CrossRefGoogle Scholar
  108. 108.
    Fishman, S. M., Papazian, J. S., Gonzalez, S., Riches, P. S., & Gilson, A. (2004). Regulating opioid prescribing through prescription monitoring programs: Balancing drug diversion and treatment of pain. Pain Medicine, 5(3), 309–324.CrossRefGoogle Scholar
  109. 109.
    Gilson, A. M., Fishman, S. M., Wilsey, B. L., Casamalhuapa, C., & Baxi, H. (2012). Time series analysis of California’s prescription monitoring program: Impact on prescribing and multiple provider episodes. Journal of Pain, 13, 103–111.CrossRefGoogle Scholar
  110. 110.
    Patrick, S. W., Fry, C. E., Jones, T. F., & Buntin, M. B. (2016). Implementation of prescription drug monitoring programs associated with reductions in opioid-related death rates. Health Affairs, 35, 1324–1332.CrossRefGoogle Scholar
  111. 111.
    Paulozzi, L., Kilbourne, E. M., & Desai, H. A. (2011). Prescription drug monitoring programs and death rates from drug overdose. Pain Medicine, 12, 747–754.CrossRefGoogle Scholar
  112. 112.
    Reifler, L. M., Droz, D., Bailey, J. E., Schnoll, S. H., Fant, R., Dart, R. C., & Bucher Bartelson, B. (2012). Do prescription monitoring programs impact state trends in opioid abuse/misuse? Pain Medicine, 13, 434–442.Google Scholar
  113. 113.
    Gugelmann, H. M., & Perrone, J. (2011). Can prescription drug monitoring programs help limit opioid abuse? The Journal of the American Medical Association, 306, 2258–2259.CrossRefGoogle Scholar
  114. 114.
    Simoni-Wastila, L., & Yang, H. K. (2006). Psychoactive drug abuse in older adults. The American Journal of Geriatric Pharmacotherapy, 4, 380–394.CrossRefGoogle Scholar
  115. 115.
    Fischer, B., Lusted, A., Roerecke, M., Taylor, B., & Rehm, J. (2012). The prevalence of mental health and pain symptoms in general population samples reporting non-medical use of prescription opioids: A systematic review and meta-analysis. Journal of Pain, 13, 1029–1044.CrossRefGoogle Scholar
  116. 116.
    Albert, S., Brason, F. W., Sanford, C. K., Dasgupta, N., Graham, J., & Lovette, B. (2011). Project Lazarus: Community-based overdose prevention in rural North Carolina. Pain Medicine (Malden, Mass.), 12(Suppl. 2), S77–S85.Google Scholar
  117. 117.
    Stewart, H., Malinowski, A., Ochs, L., Jaramillo, J., McCall, K., 3rd, & Sullivan, M. (2015). Inside Maine’s medicine cabinet: Findings from the drug enforcement administration’s medication take-back events. American Journal of Public Health, 105(1), e65–e71.CrossRefGoogle Scholar
  118. 118.
    Katz, N., Adams, E. H., Chilcoat, H., Colucci, R., Comer, S. D., Goliber, P., … Weiss, R. (2007). Challenges in the development of prescription opioid abuse-deterrent formulations. Clinical Journal of Pain, 23, 648–660.Google Scholar
  119. 119.
    Romach, M. K., Schoedel, K. A., & Sellers, E. M. (2013). Update on tamper-resistant drug formulations. Drug and Alcohol Dependence, 130, 13–23.CrossRefGoogle Scholar
  120. 120.
    Mastropietro, D. J., & Omidian, H. (2013). Current approaches in tamper-resistant and abuse-deterrent formulations. Drug Development and Industrial Pharmacy, 39, 611–624.CrossRefGoogle Scholar
  121. 121.
    Comer, S. D., Sullivan, M. A., Vosburg, S. K., Manubay, J., Amass, L., Cooper, Z. D., … Kleber, H. D. (2010). Abuse liability of intravenous buprenorphine/naloxone and buprenorphine alone in buprenorphine-maintained intravenous heroin abusers. Addiction, 105, 709–718.Google Scholar
  122. 122.
    Lavonas, E. J., Severtson, S. G., Martinez, E. M., Bucher-Bartelson, B., Le Lait, M. C., Green, J. L., … Dart, R. C. (2014). Abuse and diversion of buprenorphine sublingual tablets and film. Journal of Substance Abuse Treatment, 47, 27–34.Google Scholar
  123. 123.
    Severtson, S. G., Ellis, M. S., Kurtz, S. P., Rosenblum, A., Cicero, T. J., Parrino, M. W., … Dart, R. C. (2016). Sustained reduction of diversion and abuse after introduction of an abuse deterrent formulation of extended release oxycodone. Drug and Alcohol Dependence, 168, 219–229.Google Scholar
  124. 124.
    Bannwarth, B. (2012). Will abuse-deterrent formulations of opioid analgesics be successful in achieving their purpose? Drugs, 72, 1713–1723.CrossRefGoogle Scholar
  125. 125.
    Becker, W. C., & Fiellin, D. A. (2017). Abuse-deterrent opioid formulations—Putting the potential benefits into perspective. New England Journal of Medicine, 376, 2015–2103.CrossRefGoogle Scholar
  126. 126.
    Cicero, T. J., & Ellis, M. S. (2015). Abuse-deterrent formulations and the prescription opioid abuse epidemic in the United States: Lessons learned from OxyContin. JAMA Psychiatry, 72, 424–429.CrossRefGoogle Scholar
  127. 127.
    Lourenco, L. M., Matthews, M., & Jamison, R. N. (2013). Abuse-deterrent and tamper-resistant opioids: How valuable are novel formulations in thwarting non-medical use? Expert Opinion on Drug Delivery, 10, 229–240.CrossRefGoogle Scholar
  128. 128.
    Butler, S. F., Cassidy, T. A., Chilcoat, H., Black, R. A., Landau, C., Budman, S. H., & Coplan, P. M. (2013). Abuse rates and routes of administration of reformulated extended-release oxycodone: Initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment. The Journal of Pain, 14, 351–358.Google Scholar
  129. 129.
    Cicero, T. J., Ellis, M. S., & Surratt, H. L. (2012). Effect of abuse-deterrent formulation of OxyContin. The New England Journal of Medicine, 367(2), 187–189.CrossRefGoogle Scholar
  130. 130.
    Coplan, P. M., Kale, H., Sandstrom, L., Landau, C., & Chilcoat, H. D. (2013). Changes in oxycodone and heroin exposures in the national poison data system after introduction of extended-release oxycodone with abuse-deterrent characteristics. Pharmacoepidemiology and Drug Safety, 22, 1274–1282.CrossRefGoogle Scholar
  131. 131.
    Coplan, P. M., Chilcoat, H. D., Butler, S. F., Sellers, E. M., Kadakia, A., Karikrishnan, V., … Dart, R. C. (2016). The effect of an abuse-deterrent opioid formulation (OxyContin) on opioid-abuse related outcomes in the postmarketing setting. Clinical Pharmacology & Therapeutics, 100, 275–286.Google Scholar
  132. 132.
    Sessler, N. E., Downing, J. M., Kale, H., Chilcoat, H. D., Baumgartner, T. F., & Coplan, P. M. (2014). Reductions in reported deaths following the introduction of extended-release oxycodone (OxyContin) with an abuse-deterrent formulation. Pharmacoepidemiology and Drug Safety, 23, 1238–1246.CrossRefGoogle Scholar
  133. 133.
    Dart, R. C., Surratt, H. L., Cicero, T. J., Parrino, M. W., Severtson, S. G., Bucher-Bartelson, B., & Green, J. L. (2015). Trends in opioid analgesic abuse and mortality in the United States. The New England Journal of Medicine, 372(3), 241–248.Google Scholar
  134. 134.
    Strang, J., & Sheridan, J. (1997). Heroin prescribing in the “British system” of the mid 1990s: Data from the 1995 national survey of community pharmacies in England and Wales. Drug and Alcohol Review, 16, 7–16.CrossRefGoogle Scholar
  135. 135.
    Surratt, H. L., O’Grady, C., Kurtz, S. P., Stivers, Y., Cicero, T. J., Dart, R. C., & Chen, M. (2014). Reductions in prescription opioid diversion following recent legislative interventions in Florida. Pharmacoepidemiology and Drug Safety, 23, 314–320.Google Scholar
  136. 136.
    Johnson, H., Paulozzi, L., Porucznik, C., Mack, K., & Herter, B. (2014). Decline in drug overdose deaths after state policy changes—Florida, 2010–2012. MMWR: Morbidity and Mortality Weekly Report, 63, 569–574.Google Scholar
  137. 137.
    Brennan, T. A., Rothman, D. J., Blank, L., Blumenthal, D., Chimonas, S. C., Cohen, J. J., … Smelser, N. (2006). Health industry practices that create conflicts of interest: A policy proposal for academic medical centers. The Journal of the American Medical Association, 295, 429–433.Google Scholar
  138. 138.
    Kassirer, J. P. (2005). On the take: How medicine’s complicity with big business can endanger your health. New York: Oxford University Press.CrossRefGoogle Scholar
  139. 139.
    Meier, B. (2007). In guilty plea, Oxycontin maker to pay $600 million. New York Times. Available at

Copyright information

© The Author(s) 2020

Authors and Affiliations

  • Keith Humphreys
    • 1
  • Harold A. Pollack
    • 2
  1. 1.Veterans Affairs and Stanford University Medical CentersPalo AltoUSA
  2. 2.School of Social Service AdministrationThe University of ChicagoChicagoUSA

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