Global patterns of opioid use and dependence: harms to populations, interventions, and future action

We summarise the evidence for medicinal uses of opioids, harms related to the extramedical use of, and dependence on, these drugs, and a wide range of interventions used to address these harms. The Global Burden of Diseases, Injuries, and Risk Factors Study estimated that in 2017, 40·5 million people were dependent on opioids (95% uncertainty interval 34·3-47·9 million) and 109 500 people (105 800-113 600) died from opioid overdose. Opioid agonist treatment (OAT) can be highly effective in reducing illicit opioid use and improving multiple health and social outcomes-eg, by reducing overall mortality and key causes of death, including overdose, suicide, HIV, hepatitis C virus, and other injuries. Mathematical…

• MR
  Medical Research Council

  Awards: MR/K006525/1, MR/K023233/1
• NH
  National Health and Medical Research Council

  Award: APP1150078
• NI
  National Institute on Drug Abuse

  Awards: R01 DA037773–01A1, R01DA1104470
• NI
  National Institute of General Medical Sciences

  Award: P20GM125507