National Institute on Drug Abuse, Bethesda, MD, 20892, USA.
Mol Psychiatry. 2021 Jan;26(1):218-233. doi: 10.1038/s41380-020-0661-4. Epub 2020 Feb 4.
The current opioid epidemic is one of the most severe public health crisis in US history. Responding to it has been difficult due to its rapidly changing nature and the severity of its associated outcomes. This review examines the origin and evolution of the crisis, the pharmacological properties of opioids, the neurobiology of opioid use and opioid use disorder (OUD), medications for opioid use disorder (MOUD), and existing and promising approaches to prevention. The results of the review indicate that the opioid epidemic is a complex, evolving phenomenon that involves neurobiological vulnerabilities and social determinants of health. Successfully addressing the epidemic will require advances in basic science, development of more acceptable and effective treatments, and implementation of public health approaches, including prevention. The advances achieved in addressing the current crisis should also serve to advance the science and treatment of other substance use disorders.
目前的阿片类药物泛滥危机是美国历史上最严重的公共卫生危机之一。由于其快速变化的性质和相关后果的严重性，应对这一危机一直具有挑战性。本综述考察了危机的起源和演变、阿片类药物的药理学特性、阿片类药物使用和阿片类药物使用障碍（OUD）的神经生物学、阿片类药物使用障碍的药物治疗（MOUD）以及现有的和有前途的预防方法。综述结果表明，阿片类药物泛滥危机是一种复杂的、不断演变的现象，涉及神经生物学脆弱性和健康的社会决定因素。成功应对这一危机需要基础科学的进步，开发更可接受和有效的治疗方法，并实施公共卫生方法，包括预防。在应对当前危机方面取得的进展也应该有助于推进其他物质使用障碍的科学和治疗。
