Barriers and Best Practices on the Management of Opioid Use Disorder

J Pain Palliat Care Pharmacother. 2024 Mar;38(1):56-73. doi: 10.1080/15360288.2023.2290565. Epub 2023 Dec 15.

Abstract

Opioids refer to chemicals that agonize opioid receptors in the body resulting in analgesia and sometimes, euphoria. Opiates include morphine and codeine; semi-synthetic opioids include heroin, hydrocodone, oxycodone, and buprenorphine; and fully synthetic opioids include tramadol, fentanyl and methadone. In 2021, an estimated 5.6 million individuals met criteria for opioid use disorder. This article provides an overview of the pharmacology of heroin and non-prescription fentanyl (NPF) and its synthetic analogues, and summarizes the literature related to the management of opioid use disorder, overdose, and withdrawal. This is followed by a description of barriers to treatment and best practices for management with a discussion on recent updates and their potential impact on this patient population. This is followed by a description of barriers to treatment and best practices for management with a discussion on recent updates and their potential impact on this patient population.

Keywords: Opioid use disorder; adolescents; barriers; best practices; harm reduction; pregnancy.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Fentanyl
  • Heroin*
  • Humans
  • Methadone / therapeutic use
  • Opioid-Related Disorders* / drug therapy

Substances

  • Heroin
  • Analgesics, Opioid
  • Methadone
  • Fentanyl