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Abstract
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Substance use disorders (SUDs) are highly prevalent worldwide and a significant medical and social problem around the world.1-4 According to the UN Office on Drugs and Crime, globally, about 275 million individuals (or 5.5% of the global population aged 15-64 years) used drugs at least once in 2019.1 Among them, about 62 million people used opioids. Worldwide, about 36.3 million people had substance use disorders in 2019.
SUDs are among the leading causes of morbidity and mortality globally.1-4 SUDs are associated with various medical illnesses including infectious diseases, chronic pulmonary, cardiovascular and gastrointestinal disorders. SUDs are frequently comorbid with other psychiatric disorders including depression, anxiety, and posttraumatic stress disorder. Regretfully, most individuals with SUDs never receive treatment for SUDs.
SUDs are a significant risk factor for suicidal behavior.2 Individuals with SUDs have a 10-14 times larger risk of death by suicide compared with the general population. One investigation found that opioids were present in 20% of suicide deaths, marijuana in 10.2%, cocaine in 4.6%, and amphetamines in 3.4%.2 Many drug overdoses may be unrecognized suicides.3 Drug-overdose deaths are often categorized as "undetermined" if there is no known history of depressive disorder or a suicide note.
The United States has seen a significant increase in drug overdose deaths and suicides in the past two decades.4 Drug overdose deaths exceeded an annual rate of 100,000 for the first time in 2021. According to the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention report, there were 107,622 drug overdose deaths in the United States during 2021, an increase of nearly 15% from the 93,655 deaths in 2020.4 Over 75% of overdoses were related to the use of opioids, frequently fentanyl. The rate of drug poisoning deaths continues to increase in other countries. For example, the rate of drug poisoning deaths in England and Wales was 81.1% higher in 2021 than it was in 2012.5
Medications for opioid use disorder (OUD) are an effective treatment for patients with OUD and, frequently, need to be combined with psychotherapy.6 Three current medications for the management of OUD approved by the U.S. Food and Drug Administration include methadone (an opioid agonist), buprenorphine (a partial opioid agonist), and naltrexone (an opioid antagonist)...
Language: en |