Via NEJM: The Role of Science in Addressing the Opioid Crisis. Excerpt:
Opioid misuse and addiction is an ongoing and rapidly evolving public health crisis, requiring innovative scientific solutions. In response, and because no existing medication is ideal for every patient, the National Institutes of Health (NIH) is joining with private partners to launch an initiative in three scientific areas: developing better overdose-reversal and prevention interventions to reduce mortality, saving lives for future treatment and recovery; finding new, innovative medications and technologies to treat opioid addiction; and finding safe, effective, nonaddictive interventions to manage chronic pain. Each of these areas requires a range of short-, intermediate-, and long-term research strategies.
OVERDOSE-REVERSAL INTERVENTIONS
Every day more than 90 Americans die from opioid overdoses. Overdoses result from an opioid’s agonist effects at the mu-opioid receptor (MOR), located on brainstem neurons that control breathing. The MOR antagonist naloxone can reverse an overdose, if it is administered shortly after the overdose occurs. Although naloxone has saved tens of thousands of lives, overdoses frequently occur when no one else is around, and often no one arrives in time to administer it.
Overdose fatalities have also been fueled by the increased availability of very potent synthetic opioids such as fentanyl and carfentanil (50 and 5000 times as potent as heroin, respectively). Misuse of or accidental exposure to these drugs (e.g., laced in heroin) is associated with very high overdose risk, and naloxone doses that could reverse prescription-opioid or heroin overdoses may be ineffective. New and improved approaches are needed to prevent, detect, and reverse overdoses.