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Abstract
This article provides an overview of the current treatment of opioid-related conditions, including treatments provided by general practitioners and by specialists in substance-use disorders. The recent dramatic increase in misuse of prescription analgesics, the easy accessibility of opioids such as heroin on the streets, and the epidemic of opioid overdoses underscore how important it is for physicians to understand more about these drugs and to be able to tell patients about available treatments for substance-use disorders. Opioids include most prescription analgesics as well as products of the poppy plant (e.g., opium, morphine, and codeine). [1] Although opioids usually are prescribed to control pain, diminish cough, or relieve diarrhea, they also produce feelings of euphoria, tranquility, and sedation that may lead the patient to continue to take these drugs despite the development of serious related problems. These problems include the need to escalate doses in order to achieve these desired effects; such levels of opioids can overwhelm respiratory drive and lead to death. Opioid-use disorders are seen in persons from all educational and socioeconomic backgrounds. Recognition of such disorders has contributed to efforts to change physicians’ prescribing practices and to train first responders regarding the parenteral administration of naloxone (Narcan or Evzio), a mu-opioid receptor antagonist. By some estimates, almost 17,000 deaths per year are related to opioids; drug poisoning is one of the leading causes of accidental death in the United States. Approximately 3 million persons in the United States and almost 16 million worldwide have a current or past opioid-use disorder. The global burden of disease from opioid-related conditions approaches 11 million life-years lost from health problems, disabilities, and early death.