Progression, Outlook, and Prognosis of Opioid Use Disorder

Opioid use disorder (OUD) is a medical condition in which a person cannot control their use of opioid drugs. Opioids include prescription pain medicines like oxycodone and hydrocodone. They also include illegal substances like heroin.¹

OUD is a serious public health issue in the United States. Millions of people in the US and around the world currently live with opioid use disorder.¹

Without treatment, OUD can lead to severe health problems, including overdose and death. According to the Centers for Disease Control and Prevention (CDC), in 2022 there were more than 81,000 deaths involving opioids in the United States. This is the highest number recorded to date. Yet the medicines that can help treat OUD are underused.²

Progression of opioid use disorder

OUD often begins with the misuse of prescribed painkillers or the use of illegal opioids. Over time, occasional use can lead to regular use. This, then, can lead to physical and psychological dependence.¹

Tolerance, dependence, and overdose risk

With repeated opioid use, the body becomes tolerant. This means that the body requires higher doses to achieve the same effect. Increased use and higher doses can lead to physical reliance (dependence) on the drug.¹

As tolerance increases, so does the risk of an overdose. High doses can slow down breathing so much that breathing may stop entirely. This can lead to death. But stopping opioid use suddenly can cause withdrawal symptoms.¹

Outlook and prognosis for people with OUD

The outlook and prognosis of OUD depend on many factors. Access to treatment and support to get help are important. There is also a lot of stigma and shame surrounding OUD. For many people, getting help is difficult. There is also misinformation in the community that accessing care can lead to legal implications, which is not true.¹

With the right treatment, recovery from OUD is possible. Experts recommend a combination of medicine and behavioral treatment. The following medicines are used to treat OUD:^1,3

• Methadone
• Buprenorphine
• Naltrexone

Behavioral treatment may include:^1,3

• Counseling and therapy
• Recovery support services
• Harm reduction practices
• Contingency management in organized substance abuse treatment centers

A 2020 study looked at the outcomes of people with OUD who received monthly long-acting buprenorphine over 12 months. According to the study, participants:³

• Were better able to follow their treatment plan
• Reduced their illicit opioid use
• Reported a better quality of life

However, even with treatment, relapses are common. A 2024 study found that among people with Medicare who survived an overdose, 17 percent experienced another nonfatal overdose. About 1 percent died of an overdose within a year.^1,4

Getting access to treatment

Access to the right treatment is a major roadblock for people living with OUD. Access can vary among different groups. For example:²

• Non-Hispanic white adults are more likely to receive OUD treatment than non-Hispanic Black and Hispanic or Latino adults.
• Men and adults aged 35 to 49 are more likely to receive medicines for OUD than women and younger or older adults.

Overcoming stigma and understanding relapse

Many people with OUD face stigma and shame. This can make seeking help difficult.^1,5

Society often unfairly views addiction as a moral failing rather than a medical condition. This stigma can prevent people from accessing life-saving treatment and support. It is important to understand that relapse is a common part of recovery, not a sign of failure.^1,5

Like other chronic health conditions such as diabetes or heart disease, OUD requires ongoing management. Relapses can happen, but they provide a chance to adjust the treatment plan and continue moving forward. Compassion and support from loved ones and healthcare providers are crucial in helping people stay on the path to recovery.⁵

Early intervention is key

OUD is a serious condition with significant health risks. Early intervention and access to effective treatments are crucial for improving outcomes. Addressing barriers to treatment and increasing the use of medicines for OUD can help reduce the impact of this disorder on society as a whole.^1,5