The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction

Andrew Kolodny, David T. Courtwright, Catherine S. Hwang, Peter Kreiner, John L. Eadie, Thomas W. Clark, G. Caleb Alexander

Research output: Contribution to journalReview articlepeer-review

756 Scopus citations


Public health authorities have described, with growing alarm, an unprecedented increase inmorbidity and mortality associated with use of opioid pain relievers (OPRs). Efforts to address the opioid crisis have focused mainly on reducing nonmedical OPR use. Too often overlooked, however, is the need for preventing and treating opioid addiction, which occurs in both medical and nonmedical OPR users. Overprescribing of OPRs has led to a sharp increase in the prevalence of opioid addiction, which in turn has been associated with a rise in overdose deaths and heroin use. A multifaceted public health approach that utilizes primary, secondary, and tertiary opioid addiction prevention strategies is required to effectively reduce opioid-related morbidity and mortality. We describe the scope of this public health crisis, its historical context, contributing factors, and lines of evidence indicating the role of addiction in exacerbating morbidity and mortality, andwe provide a framework for interventions to address the epidemic of opioid addiction.

Original languageEnglish (US)
Pages (from-to)559-574
Number of pages16
JournalAnnual review of public health
StatePublished - Mar 18 2015


  • Addiction
  • Chronic pain
  • Heroin
  • Opioid
  • Overdose deaths
  • Prescription drug abuse

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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