America’s Opioid Epidemic: a Comprehensive Review and Look into the Rising Crisis

  • Peter S. Ostling
  • Kelly S. Davidson
  • Best O. Anyama
  • Erik M. Helander
  • Melville Q. Wyche
  • Alan D. KayeEmail author
Other Pain (A Kaye and N Vadivelu, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Other Pain


Purpose of Review

In the USA, there has been a sharp increase in heroin, prescription opiate, and illicitly manufactured fentanyl abuse with overdoses tripling since the 1990s. Several states have been deemed as “high-burden” abuse states where there is a greater proportion of synthetic opiate use. During the same period that prescription limitations were initially implemented throughout the country, the fentanyl epidemic started nationwide.

Recent Findings

In the setting of data demonstrating an almost fourfold increase in overdose deaths from 1999 to 2008, states began restricting access to Food and Drug Agency (FDA) approved opioid medications. Another factor further exacerbating the opioid crises is that the cost of all formulations of naloxone has increased significantly over the past several years.


In order to combat the opioid epidemic, stricter prescribing practices and prescription-monitoring programs have been instituted. Also, improvements in abuse-deterrent strategies for all opioid preparations can play an important role by increasing the safety of these medications and is a major focus of the FDA.


Fentanyl Heroin Opioid abuse Opioid addiction Opioid epidemic Opioid overdose 


Compliance with Ethical Standards

Conflict of Interest

Dr. Ostling, Dr. Davis, Dr. Helander, and Dr. Wyche declare no conflicts of interest.

Dr. Kaye is a speaker for Depomed, Inc. and Merck, Inc. He also reports that he has been a member of the FDA Advisory Board on Anesthetics, Analgesics, and Addiction Medicine since 2012.

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.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Peter S. Ostling
    • 1
  • Kelly S. Davidson
    • 1
  • Best O. Anyama
    • 1
  • Erik M. Helander
    • 1
  • Melville Q. Wyche
    • 2
  • Alan D. Kaye
    • 1
    • 2
    Email author
  1. 1.Department of AnesthesiologyLSUHSCNew OrleansUSA
  2. 2.Department of PharmacologyLSUHSCNew OrleansUSA

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