This month marks the launch of the thematic series, “Health Services Research for Opioid Use Disorders”, a compilation of peer reviewed articles on prevention and treatment for the public health emergency of opioid misuse and opioid use disorders. Papers will speak to the epidemic and the strategies being developed to address it. Due to their structural similarity, this special issue uses the umbrella term “opioids” to also include opiates.
Public health crisis
North America and Europe are currently grappling with a public health crisis associated with widespread access to prescription opioid analgesics, enhanced purity of heroin, the introduction of potent fentanyl compounds, and a rising tide of opioid overdose fatalities. In the United States, prescriptions for hydrocodone and oxycodone exploded beginning in the late 1990s. Now, more than 2 million individuals in the United States have an opioid use disorder. Most of these individuals were introduced to opioids via a prescription for an opioid analgesic (either for themselves or another party).
more than 2 million individuals in the United States have an opioid use disorder
Prescription drug monitoring programs have resulted in a drop in the prescription of opioid analgesics and patients dependent on opioids feel compelled to shift to the use of illicit heroin or a synthetic opioid. As a result, overdoses are on the rise and overdose fatalities exceeded 63,000 in 2016. Fentanyl derivatives now make a major contribution to the current opioid crisis, and over a short period of time they have become the substances most associated with overdose mortality. Drug overdose deaths remain high in Europe, and according to the European Monitoring Centre for Drugs and Drug Addiction, opioids are implicated in the majority of cases. These deaths have become the face of the opioid epidemic.
The good news is that treatment works. A recent study found that treatment of opioid use disorder with either methadone or buprenorphine following a nonfatal opioid overdose is associated with significant reductions in opioid related mortality. A barrier to positive long term outcomes, however, is the lack of access and retention in treatment. Exciting advances are being made to reformulate some of the traditional opioid agonist therapy (i.e., methadone and buprenorphine) to improve patient adherence to treatment. An opioid antagonist therapy (i.e., extended-release naltrexone) provides an alternative to agonist therapy. Psychosocial therapy combined with either agonist or antagonist medication facilitates healthier lives and lifestyles.
Naloxone distribution and opioid overdose education have saved many lives. Programs such as Get Naloxone Now (https://www.getnaloxonenow.org) are effectively training care providers and community members on how to save lives.
Call for papers
Addiction health services research is on the front lines in the fight to address the opioid epidemic. The papers in this special issue illustrate applications of these tools in North American and Europe. Manuscripts submitted before April 30, 2019 will be reviewed for inclusion in the issue. See the call for papers announcement.
This collection of articles is not sponsored, and the articles will be subjected to the journal’s standard peer-review process overseen by BMC Health Services Research Associate Editor Kim Hoffman and Guest Editor Dennis McCarty, who declare no competing interests.
If you have any research you would like us to consider for inclusion in the series, please email us at firstname.lastname@example.org