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Policy Response to the Use and Misuse of Opioids in the United States

What are opioids?

Opioids are natural or synthetic chemicals that are used for pain management. Opioids include prescription drugs (such as morphine, codeine, methadone, and oxycodone), synthetic drugs (such as fentanyl and tramadol), and heroin.

​Access a primer on key terms and concepts for understanding the opioid epidemic

What do we know about the increased use and misuse of opioids?

Learn what happens when prescriptions become the problem (under the tab, The Problem)
Read about the significant rise in the use and misuse of pharmaceutical and illegally-made fentanyl (under the tab, The Problem)
Understand the sharp increases in heroin use across the U.S. among men and women, most age groups, and all income levels (under the tab, The Problem)
Download an infographic about the scope of the opioid epidemic
This graphic shows that in 2016 116 people died daily from opioid-related overdoses and 11.5 million people misued prescription opioids.
Source: https://www.hhs.gov/opioids/

Why do people misuse opioids?

The most common reason that adults misuse prescription opioids, according to the 2015 National Survey on Drug Use and Health, is to relieve physical pain. The survey found that other common reasons include a desire to relax, assist with sleep, manage emotions, and increase or decrease the effects of other drugs.  

Read what people say about why they misuse prescription drugs

Prevalence of Opioid Use among Adults with Mental Illnesses

Results from the 2015 National Survey on Drug Use and Health reveal that 11.7 million adults (4.8% of the population) misused opioids in the past year, and 9.8 million adults (4%) had a serious mental illness in the past year. Survey results indicate that approximately 1.5 million adults misused opioids and had a mental illness in the past year. 
This venn diagram shows that there are 9,8 million adults with mental illness, 11.7 million adults who misused opioids in the past year, and 1.5 million who have co-occurring mental illness and opioid addiction
Source: SAMHSA CBHSQ Report, January 25, 2017
Learn more from SAMHSA about the overlap between mental illness and opioid misuse
Access an article showing that people with mental health disorders receive 60 million (or more than half) of the total 115 million opioid prescriptions in the U.S.

Opioid-Related Deaths

From 2015 to 2016, the rate of deaths due to synthetic opioids, including fentanyl and tramadol, doubled from 3.1 deaths per 100,000 to 6.2 deaths per 100,000. The rate is nearly 7 times as high as it was in 2010 (1 death per 100,000).  
This map shows the highest concentration of opioid-related deaths in the northeastern United States and parts of the midwest.
Understand the prevalence of drug overdose deaths in the U.S. from 1999 to 2016
Access a report showing that synthetic opioid (other than methadone) death rates increased across all demographics, regions, and numerous states
Read about prescription opioid overdose deaths
Learn more about heroin overdose deaths

Current Responses to the Crisis

States are using many promising strategies to address the opioid crisis. Approaches include increasing access to substance abuse treatments like Medication-Assisted Treatment (MAT), introducing prescription drug monitoring programs, targeting overdose reversing drugs, improving prescribing practices, and educating patients about non-pharmacological pain management. Many of these strategies are featured below. 
New proposed legislation​: H.R.6823 - Supporting Positive Outcomes After Release Act
Congressman Bobby Scott (D-VA-03) and Senator Edward J. Markey (D-Mass) have introduced this legislation that would prohibit states from terminating inmates' Medicaid coverage while they are incarcerated, instead allowing states to temporarily suspend such coverage. This would allow individuals to more readily access needed treatment in the critical days and weeks after release.  
The U.S. Department of Health and Human Services offers a 5-point strategy to combat the opioid crisis. Strategies include improved prevention, treatment and recovery services, data collection and application, methods for pain management, targeting of overdose reversing drugs, and research.

Learn more about the strategy and find other information from HHS about the opioid crisis 
Medicaid is an important tool in addressing the opioid crisis. It provides health care coverage for people who have opioid use disorder, and increases capacity for states to provide treatment and intervention. Medicaid recipients are more likely than those with private coverage or those who are uninsured to successfully receive treatment for substance use disorders. 

Explore an infographic about Medicaid’s role in addressing the opioid crisis

Watch a SAMHSA video on how stakeholders are partnering for
​opioid addiction prevention

Read more about strategies states can use to address the opioid crisis, and about state successes 
Access an issue brief summarizing experiences and key ingredients in coordinating state opioid strategies 
Learn more about the CDC’s Prevention for States program 
​Look up your state in a detailed overview of legislation, including limitations and exceptions to prescribing policies 
Learn more about the benefits of MAT in fighting the opioid crisis 
 Learn how CCBHCs are addressing the opioid epidemic
Read a review of the evidence that links trauma and childhood adverse events to opioid addiction, and how states can offer trauma-informed care 
Access The American Academy of Addiction Psychiatry’s resources for practitioners and for people receiving treatment 

Request technical assistance
Views expressed on the Academy for Policymakers web site do not necessarily represent those of our Center or any federal agency. Our mission is to share the latest policy information and the perspectives of a variety of stakeholders without endorsement.  

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