Current Addiction Reports

, Volume 5, Issue 4, pp 454–463 | Cite as

The Deepening Opioid Crisis in North America: Historical Context and Current Solutions

  • Joseph H. DonroeEmail author
  • M. Eugenia Socias
  • Brandon D. L. Marshall
Opioids (D Fiellin and J Donroe, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Opioids


Purpose of Review

The purpose of this review is to (1) detail the historical context behind the rise of opioid use disorder (OUD) and opioid-related harms in the United States (US) and Canada, (2) describe the epidemiology of OUD in these two countries, and (3) discuss current strategies being employed to address this public health emergency in North America.

Recent Findings

Opioid-related overdose has become a leading cause of unintentional injury related death in North America. Deaths have risen in parallel with opioid prescribing and the rising prevalence of unintentional exposure to highly potent synthetic opioids. At the same time, rates of injection drug use-related infections such as hepatitis C and endocarditis have also increased.


Both Canada and the US have implemented policy changes and interventions at the national and local levels in an attempt to stem rising opioid attributable morbidity and mortality. In many settings, the collective goal has been to increase access to treatment of OUD, expand harm reduction interventions (including improved access to naloxone), and develop and disseminate guidelines on the safe prescribing of opioids for non-cancer pain and the management of OUD.


Opioid Addiction Overdose North America Fentanyl Heroin 



M. Eugenia Socias is supported by a Michael Smith Foundation for Health Research (MSFHR)/St Paul’s Foundation Scholar Award.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Joseph H. Donroe
    • 1
    Email author
  • M. Eugenia Socias
    • 2
    • 3
  • Brandon D. L. Marshall
    • 4
  1. 1.Department of Internal MedicineYale University School of MedicineNew HavenUSA
  2. 2.British Columbia Centre on Substance UseVancouverCanada
  3. 3.Department of MedicineUniversity of British ColumbiaVancouverCanada
  4. 4.Department of EpidemiologyBrown University School of Public HealthProvidenceUSA

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