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The Natural History, Clinical Course, and Long-Term Recovery from Opioid Use Disorders

  • Elizabeth A. EvansEmail author
  • Yih-Ing Hser
Chapter
Part of the Current Clinical Psychiatry book series (CCPSY)

Abstract

Studies of the long-term course of opioid use disorder (OUD) underscore how the condition is exacerbated by factors such as interactions with the criminal justice system, limited access to medications to treat OUD, chronic unemployment and conditions of poverty, physical/psychological trauma and related mental illness, social isolation, and poor social support. Developments in pharmacotherapies for OUD and innovative means of administration have yielded important advances in effective medication-based treatments, yet social and political structures remain as obstacles in some regions of the United States and other parts of the world affected by OUD. Changes in perceptions about OUD as a chronic brain disease and about the effectiveness of pharmacotherapies for OUD indicate a public health approach may slowly supersede the criminal justice approach to addressing OUD. This chapter provides an overview of OUD problems as they have emerged and as they are societally and clinically addressed, emphasizing the management and treatment of OUD with effective use of available pharmacotherapies and within environments that are supportive of recovery.

Keywords

Opioid Heroin Opioid use disorder Heroin use disorder Addiction Natural history Longitudinal Prospective cohort studies Life course Methadone Buprenorphine Naltrexone Long-term recovery 

Notes

Acknowledgments

Dr. Evans is supported by the Greenwall Foundation, the National Institute on Drug Abuse (NIDA) UG3 DA0044830-02S1, and Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) Grant No. 1H79T1081387-01. Dr. Hser is supported by NIDA R33DA045844 and UG1 DA013035.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts AmherstAmherstUSA
  2. 2.Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California Los AngelesLos AngelesUSA

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