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A basic science perspective on pain research and the opioid epidemic

An opioid epidemic driven by a lack of pain management options

An estimated 138 people die each day in the United States and Canada from opioid-related drug overdoses1. A staggering forty percent of these deaths are caused by prescription opioids. Further, 2 million people in the US suffer from opioid use disorder (OUD), illustrating a large patient population at risk of overdose death.

As these numbers continue to climb, patients, physicians, scientists, and policy makers worldwide are working together to identify ways to alleviate the burden of this epidemic. To facilitate an informed conversation amongst these stakeholders, this article provides a basic science perspective on the mechanisms behind how opioids relieve pain, facilitate addiction, and cause overdose deaths while discussing recent preclinical findings that have direct clinical implications.

The history of the opioid epidemic

The origin of the opioid epidemic stems from a series of events over several decades that led to a perfect storm of opioid misuse potential. During the 1990s, the American Pain Society brought attention to the need of properly caring for and managing pain by campaigning for it to be considered as the “fifth vital sign”2. At a similar time, the pharmaceutical industry began aggressively marketing their opioid products to meet the need while downplaying their risk of addiction3. This led to an initial wave of opioid use disorders and overdose deaths.