"These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

This book addresses opioids and opioid use disorders from epidemiological, clinical, and public health perspectives. It covers detailed information on the nature of opioids, their effects on the human body and brain, prevention, and treatment of opioid addiction. Unlike other texts, the first section of this volume builds a strong historical, neurobiological, and phenomenological foundation for a deep understanding of the topic and the patient. The second section addresses the most challenging issues clinicians face, including pharmacological and psychosocial treatments, harm reduction approaches, alternative approaches to pain management for the non-specialist, and prescribing guidelines. Treating Opioid Addiction is a valuable resource for psychiatrists, psychologists, addiction medicine physicians, primary care physicians, drug addiction counselors, students, trainees, scholars, and public health officials interested in the effects and impact of opioids in the clinical and epidemiological context.

Throughout the world, hundreds of thousands of people are addicted to opiates. The human, economic, and societal costs of this addiction are staggering: more than one-quarter of prison inmates are incarcerated for drug offenses and there has been a dramat.

A major problem in the treatment of opioid dependence has been the persistence of relapse despite detoxification and enforced prolonged abstention from drug use, with or without conventional psychotherapy and other efforts at rehabilitation. Both initial addiction and subsequent relapses are usually ascribed to the quest for opioid-produced euphoria in persons with character disorders. This formulation is in accord with one-half of the common sense "pleasure-pain" principle, but it ignores the other half, namely, the long-lasting dysphoric consequences of re peated opioid use (distressing abstinence phenomena, sexual distur bances, disruption of marital status, unemployment, enmeshment in criminal activities, arrests, and imprisonment). In any case, the pleasure-pain principle is an empty tautology since it is incapable of refutation by any conceivable objective data that might seem contradic tory, inasmuch as it can be "saved" by invocation of untestable uncon scious intervening variables. Less tied to the pleasure-pain principle is the view that relapse is due to long-lasting sequelae of previous opioid addiction, resulting from complex conditioning processes, both operant and classical, involving pharmacological, environmental, social and personal variables. In this view, relapse is not simply a re-enactment of initial opioid use, but is a "disease, sui generis" a disease of its own kind. The factors contributing to this disease, sui generis are reviewed in this book.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration (FDA)-approved medications used to treat opioid use disorder (OUD)—methadone, naltrexone, and buprenorphine—and provides guidance for healthcare professionals and addiction treatment providers on appropriate prescribing practices for these medications and effective strategies for supporting the patients utilizing medication for the treatment of OUD. The goal of treatment for opioid addiction or OUD is remission of the disorder leading to lasting recovery. Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. This TIP also educates patients, families, and the general public about how OUD medications work and the benefits they offer. Related products: Medication-Assisted Treatment of Opioid Use Disorder: Pocket Guide A Shared Burden: The Military and Civilian Consequences of Army Pain Management Since 2001 Click our Alcoholism, Smoking & Substance Abuse collection to find more resources on this topic.