Ch. 4: Summary

In this module, you were introduced to several different types of opioid substances and learned definitions of opioids, opiates, and narcotics. How opioids are used/misused and their effects were presented, along with information concerning their potential health and addiction risks—including risks associated with routes of administration (e.g., injection use). The nature of opioid overdose was described and the use of opioid overdose reversal drugs explained. In addition, medications approved for use in medication-assisted treatment (MAT) of opioid use disorder were described along with how they might be used in treatment and recovery (more on this topic in a later module about pharmacotherapy). The story of “how we got into this mess” called the opioid epidemic was outlined; a resource for learning more about the different interwoven threads is the Dreamland book (Quinones, 2015). The Preface to the NAS (2017) report represents a strong summary to much of the content presented in this module. They indicate that it is clear “that the opioid epidemic will not be controlled without deploying multiple policy tools. Increasing access to treatment for individuals with OUD is imperative, together with a substantial program of research to develop new nonaddictive treatments for pain.” The report goes on to recommend changes in the health care system where collective responsibility for over-prescribing resides, law enforcement efforts to curtail trafficking in illegally manufactured and distributed opioids (in the U.S. and abroad), and a strong commitment to prevention and treatment of substance use disorders more generally.

This module concluded with a discussion of the effects of opioid exposure during prenatal development and how neonatal withdrawal syndrome (NWS) might be managed. At this point, you are prepared for the next module which looks into other forms of prescription drug misuse and use of medications for managing and supporting recovery from substance use disorder. Several additional substances are examined, including over-the-counter substances, that did not fit easily into the “types” we have discussed so far.