Opioids

Opioids are a class of drugs that include heroin and prescription pain relievers that produce analgesia and euphoria. More than 2 million Americans have an opioid use disorder. Acute effects include analgesia, respiratory depression, miosis, and euphoria. Overdose is a serious complication of opioid use, characterized by depressed level of consciousness and respiratory depression. It can be treated with naloxone. Withdrawal symptoms include dysphoria, yawning, tearing, diarrhea, cramps, nausea, and piloerection. Buprenorphine, methadone, clonidine, and lofexidine can be used to ameliorate the symptoms of withdrawal. However, supervised withdrawal alone rarely leads to long-term abstinence. There are a number of psychosocial treatments, including self-help groups, outpatient therapy, and residential treatment; the data on their effectiveness are limited. Pharmacotherapy with an opioid agonist (methadone or buprenorphine) is the most effective treatment. Long-acting injectable naltrexone, an opioid antagonist, is also effective, but it is more difficult to initiate.

Visualizing Age, Period, and Cohort Patterns of Substance Use in the U.S. Opioid Crisis

Descriptions of the contemporary U.S. opioid crisis emphasize several “waves” of overdose deaths. However, a focus on trends in overdose deaths may obscure important sociological dynamics. The authors provide heatmap visualizations of estimated annual rates of past-year substance use, rather than overdose deaths, for prescription pain relievers and heroin. These visualizations are based on weighted analyses of self-reports, cross-classified by age and period, collected as part of the National Survey on Drug Use and Health from 2002 to 2017. Whereas descriptions of the U.S. opioid crisis tend to focus on period dynamics, these visualizations indicate that cohort patterns of drug use are also evident in addition to well-known age variation. A substantive focus on cohort patterns highlights the possibility that cohorts of people who use drugs may remain at risk for overdose in the years to come. These findings suggest that policies aimed only at restricting opioid availability may have limited effects.

Examining the Relationship Between Strain and the Use of Nonmedical Prescription Drugs Among College Students

The study of nonmedical prescription drug use (NMPDU) on college campuses is of importance, as college students tend to engage in NMPDU more often than their same-age peers not attending college. Typical correlates of NMPDU include need for alertness, perception of peer use, desire to get high, and use of other drugs including alcohol and marijuana. Few studies have explored the relationship between strain, depression, and NMPDU among college students. Using general strain theory as the theoretical framework, the current study aims to add to the literature on NMPDU by exploring the role that strain and depression play in the prevalence of nonmedical prescription stimulant, tranquilizer/sedative, and pain reliever use at a midsized university. Results support the relationship proposed by strain theorists for both nonmedical use of prescription pain relievers and tranquilizers/sedatives, but not stimulants. Policy implications and future areas of research are discussed.

The Opioid Epidemic and the Labor Market

Drug overdoses now account for more deaths in the United States than traffic deaths or suicides, and most of the increase in overdose deaths since 2010 can be attributed to opioids--a class of drugs that includes both prescription pain relievers and illegal narcotics. We look at trends in drug use and overdose deaths to document how the opioid epidemic has evolved over time and to determine whether it could be large enough to impact the labor force.