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<p class="pretitle"><a href="/about-nih/what-we-do/impact-nih-research/improving-health">Improving Health</a></p><div class='syndicate'><h1>Substance Use</h1><div><div class="flipcard-container masonry-container">
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<h3>Opioid Use Disorder</h3>
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<p></p><div class="media media-element-container media-feature_teaser"><div id="file-72781" class="file file-image file-image-jpeg">
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<h2 class="element-invisible"><a href="/impact/substance-use-opioid-use-disorder.jpg">substance-use--opioid-use-disorder.jpg</a></h2>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium/public/about-nih/impact/substance-use--opioid-use-disorder.jpg?itok=qmNQ5eEg&timestamp=1674837796 1x" media="screen and (min-width: 800px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium-small/public/about-nih/impact/substance-use--opioid-use-disorder.jpg?itok=v8ERRWLg&timestamp=1674837796 1x" media="screen and (min-width: 600px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-small/public/about-nih/impact/substance-use--opioid-use-disorder.jpg?itok=2rb2CAFM&timestamp=1674837796 1x" media="screen and (min-width: 480px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-tiny/public/about-nih/impact/substance-use--opioid-use-disorder.jpg?itok=-8mTMept&timestamp=1674837796 1x" media="screen and (min-width: 0)"></source>
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<!--[if IE 9]></video><![endif]-->
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<img class="media-element" src="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium/public/about-nih/impact/substance-use--opioid-use-disorder.jpg?itok=qmNQ5eEg&timestamp=1674837796" alt="A female health care provider in a white lab coat and female patient consult." title="Opioid Use Disorder" />
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</picture> </div>
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<p>NIH-supported research led to the development of buprenorphine, a medication treatment for opioid addiction. In people who experienced a non-fatal overdose, long-term buprenorphine reduces their likelihood of dying from overdose in the future by 38%.</p>
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<p class="credit">Image credit: Scott Housley</p>
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<ul class="spaced">
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||
<li>In 2017, the opioid crisis was declared a public health emergency by HHS.</li>
|
||
<li>In 2022, 6.1 million Americans had an opioid use disorder and opioid overdose was the leading cause of death for Americans ages 18-49. For every fatal overdose, it is estimated that there are 15 non-fatal overdoses, which have the potential to cause long-term brain injury.</li>
|
||
<li>Buprenorphine, approved by FDA in 2002 to treat addiction to opioids, works by helping reduce withdrawal symptoms and drug craving.</li>
|
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<h3>Overdose Reversal</h3>
|
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<p></p><div class="media media-element-container media-feature_teaser"><div id="file-72776" class="file file-image file-image-jpeg">
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<h2 class="element-invisible"><a href="/impact/substance-use-naloxone.jpeg">substance-use--naloxone.jpeg</a></h2>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium/public/about-nih/impact/substance-use--naloxone.jpeg?itok=DndSR-qM&timestamp=1674837796 1x" media="screen and (min-width: 800px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium-small/public/about-nih/impact/substance-use--naloxone.jpeg?itok=0cTk5Ler&timestamp=1674837796 1x" media="screen and (min-width: 600px)"></source>
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||
<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-small/public/about-nih/impact/substance-use--naloxone.jpeg?itok=tXipW3G2&timestamp=1674837796 1x" media="screen and (min-width: 480px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-tiny/public/about-nih/impact/substance-use--naloxone.jpeg?itok=N1KR4Zmq&timestamp=1674837796 1x" media="screen and (min-width: 0)"></source>
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<!--[if IE 9]></video><![endif]-->
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<img class="media-element" src="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium/public/about-nih/impact/substance-use--naloxone.jpeg?itok=DndSR-qM&timestamp=1674837796" alt="Red pouch open to display a Narcan nasal spray" title="Naloxone" />
|
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</picture> </div>
|
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<p>NIH research led to the development of easy-to-use naloxone nasal spray, a life-saving tool that rapidly reverses the effects of opioid overdose. By 2014, over 30 states had naloxone access laws in place, and in those states opioid overdose deaths decreased by 14%.</p>
|
||
|
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<p class="credit">Image credit: National Institute on Drug Abuse, NIH</p>
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<ul class="spaced">
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||
<li>In 2015, FDA approved the first naloxone nasal spray—Narcan®—developed as a result of NIH-funded research.</li>
|
||
<li>Naloxone is now the standard treatment to reverse opioid overdose and can be used by both medical professionals and laypersons without formal training.</li>
|
||
<li>High rates of naloxone distribution among laypersons and emergency personnel could avert 21% of opioid overdose deaths, and the majority of overdose death reduction would result from increased distribution to laypersons.</li>
|
||
<li>In 2023, FDA approved the first non-prescription versions of naloxone and approved a new opioid overdose reversal medication—nalmefene—that lasts longer than naloxone.</li>
|
||
</ul>
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<h3>Tobacco Smoking</h3>
|
||
|
||
<p></p><div class="media media-element-container media-feature_teaser"><div id="file-72786" class="file file-image file-image-jpeg">
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<h2 class="element-invisible"><a href="/impact/substance-use-tobacco-use.jpg">substance-use--tobacco-use.jpg</a></h2>
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<!--[if IE 9]><video style="display: none;"><![endif]-->
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium/public/about-nih/impact/substance-use--tobacco-use.jpg?itok=YrA1pJb-&timestamp=1674837796 1x" media="screen and (min-width: 800px)"></source>
|
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium-small/public/about-nih/impact/substance-use--tobacco-use.jpg?itok=Iweq8kVR&timestamp=1674837796 1x" media="screen and (min-width: 600px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-small/public/about-nih/impact/substance-use--tobacco-use.jpg?itok=b2G-8nrz&timestamp=1674837796 1x" media="screen and (min-width: 480px)"></source>
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<source srcset="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-tiny/public/about-nih/impact/substance-use--tobacco-use.jpg?itok=i74WLhPO&timestamp=1674837796 1x" media="screen and (min-width: 0)"></source>
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<!--[if IE 9]></video><![endif]-->
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<img class="media-element" src="https://www.nih.gov/sites/default/files/styles/feature_teaser_breakpoint-medium/public/about-nih/impact/substance-use--tobacco-use.jpg?itok=YrA1pJb-&timestamp=1674837796" alt="Woman blowing bubbles" title="Tobacco Use" />
|
||
</picture> </div>
|
||
|
||
|
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</div>
|
||
</div>
|
||
|
||
<p>NIH-funded research on tobacco use has informed public policy interventions and health practices, supporting a two-thirds reduction in smoking over the past 50 years and contributing to a sharp drop in lung cancer rates.</p>
|
||
|
||
<p class="credit">Image credit: Gianandrea Villa on Unsplash</p>
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<ul class="spaced">
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||
<li>Smoking in U.S. adults hit an all-time low of 11.5% in 2021—down 75% since the U.S. Surgeon General issued a landmark report on the health consequences of smoking in 1964.</li>
|
||
<li>Smoke-free policies decrease smoking rates, help to promote quitting, de-normalize tobacco use, and reduce exposure to secondhand smoke.</li>
|
||
<li>Increasing the price of tobacco products through taxation prevents smoking initiation, promotes quitting, and reduces prevalence and intensity of tobacco use among youth and adult users.</li>
|
||
<li>NIH-funded programs provide tools and tips to the public on quitting smoking.</li>
|
||
</ul>
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</div>
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<h3>E-Cigarettes</h3>
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<p>In an effort to curb tobacco use in children and teenagers, in 2020 FDA released a policy—informed by NIH-supported research—to restrict the sale of e-cigarette flavors that appeal to kids, including fruit and mint flavors. This has led FDA to deny marketing applications for over 55,000 flavored e-cigarette products.</p>
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<p class="credit">Image credit: Drew Walker on Unsplash</p>
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<ul class="spaced">
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<li>The NIH-supported Population Assessment of Tobacco and Health (PATH) study findings indicate that flavored e-cigarette products appeal to youth and promote initiation of vaping. </li>
|
||
<li>The NIH-supported Monitoring the Future (MTF) study findings indicate that youth are particularly attracted to cartridge-based e-cigarette flavors such as fruit and mint.</li>
|
||
<li>Data from MTF show that, prior to 2020, there were dramatic increases in teen vaping, which leveled off in 2020 and decreased in 2021.</li>
|
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<h2>References</h2>
|
||
|
||
<h3>Opioid Use Disorder</h3>
|
||
|
||
<ol>
|
||
<li>Medication-Assisted Treatment for Opioid Use Disorder: <a href="https://www.nationalacademies.org/our-work/medication-assisted-treatment-for-opioid-use-disorder" target="_blank">https://www.nationalacademies.org/our-work/medication-assisted-treatment-for-opioid-use-disorder(link is external)</a></li>
|
||
<li>Article: As Opioid Deaths Surge, Biden Team Moves To Make Buprenorphine Treatment Mainstream: <a href="https://www.npr.org/2021/04/27/990997759/as-opioid-deaths-surge-biden-team-moves-to-make-buprenorphine-treatment-mainstre#:~:text=As%20Opioid%20Deaths%20Surge%2C%20Biden%20Team%20Moves%20To,the%20country%20where%20the%20drug%20is%20rarely%20prescribed" target="_blank">https://www.npr.org/2021/04/27/990997759/as-opioid-deaths-surge-biden-team-moves-to-make-buprenorphine-treatment-mainstre#:~:text=As%20Opioid%20Deaths%20Surge%2C%20Biden%20Team%20Moves%20To,the%20country%20where%20the%20drug%20is%20rarely%20prescribed(link is external)</a></li>
|
||
<li>Article: Research to Address the Real-Life Challenges of Opioid Crisis: <a href="https://directorsblog.nih.gov/tag/buprenorphine/">https://directorsblog.nih.gov/tag/buprenorphine/</a></li>
|
||
<li>Opioid Addiction: <a href="https://www.nih.gov/about-nih/what-we-do/nih-turning-discovery-into-health/opioid-addiction">https://www.nih.gov/about-nih/what-we-do/nih-turning-discovery-into-health/opioid-addiction</a></li>
|
||
<li>Article: Taking Stock of NIDA’s Achievements and Looking to the Future: <a href="https://archives.drugabuse.gov/about-nida/noras-blog/2017/01/taking-stock-nidas-achievements-looking-to-future">https://archives.drugabuse.gov/about-nida/noras-blog/2017/01/taking-stock-nidas-achievements-looking-to-future</a></li>
|
||
<li>Larochelle MR, et al. <em>Ann Intern Med</em>. 2018;169(3):137-145. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/29913516/">29913516</a>.</li>
|
||
<li>National Opioids Crisis: Help and Resources: <a href="https://www.hhs.gov/opioids/index.html" target="_blank">https://www.hhs.gov/opioids/index.html(link is external)</a></li>
|
||
<li>CDC. Wide-ranging ONline Data for Epidemiologic Research, Multiple Causes of Death 1999-2022. <a href="https://wonder.cdc.gov/wonder/help/mcd.html" target="_blank">https://wonder.cdc.gov/wonder/help/mcd.html(link is external)</a></li>
|
||
<li>SAMHSA. 2021 National Survey on Drug Use and Health, 2022. <a href="https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report">https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report</a></li>
|
||
<li>U.S. Government Accountability Office. Opioid Crisis: Status of Public Health Emergency Authorities, 2018. <a href="https://www.gao.gov/products/gao-18-685r">https://www.gao.gov/products/gao-18-685r</a></li>
|
||
<li>Casillas SM, et al. <em>Injury Prevention</em>, 2024. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/38290778/">38290778</a>.</li>
|
||
</ol>
|
||
|
||
<h3>Overdose Reversal</h3>
|
||
|
||
<ol>
|
||
<li>McClellan C, et al. <em>Addict Behav</em>. 2018;86:90-95. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/29610001/">29610001</a>.</li>
|
||
<li>Townsend T, et al. <em>Int J Drug Policy</em>. 2020;75:102536. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31439388/">31439388</a>.</li>
|
||
<li>U.S. Surgeon General’s Advisory on Naloxone and Opioid Overdose: <a href="https://www.hhs.gov/surgeongeneral/priorities/opioids-and-addiction/naloxone-advisory/index.html" target="_blank">https://www.hhs.gov/surgeongeneral/priorities/opioids-and-addiction/naloxone-advisory/index.html(link is external)</a></li>
|
||
<li>Article: NARCAN Nasal Spray: Life-Saving Science at NIDA: <a href="https://archives.drugabuse.gov/about-nida/noras-blog/2015/11/narcan-nasal-spray-life-saving-science-nida">https://archives.drugabuse.gov/about-nida/noras-blog/2015/11/narcan-nasal-spray-life-saving-science-nida</a></li>
|
||
<li>Article: Taking Stock of NIDA’s Achievements and Looking to the Future: <a href="https://archives.drugabuse.gov/about-nida/noras-blog/2017/01/taking-stock-nidas-achievements-looking-to-future">https://archives.drugabuse.gov/about-nida/noras-blog/2017/01/taking-stock-nidas-achievements-looking-to-future</a></li>
|
||
<li>Article: Surgeon general urges more Americans to carry overdose antidote naloxone: <a href="https://www.chicagotribune.com/nation-world/ct-surgeon-general-naloxone-20180405-story.html" target="_blank">https://www.chicagotribune.com/nation-world/ct-surgeon-general-naloxone-20180405-story.html(link is external)</a></li>
|
||
<li>Article: Teaching Children How to Reverse an Overdose. <a href="https://www.nytimes.com/2020/02/23/us/opioids-tennessee-narcan-training.html" target="_blank">https://www.nytimes.com/2020/02/23/us/opioids-tennessee-narcan-training.html(link is external)</a></li>
|
||
<li>Drug Overdose Deaths in the U.S. Top 100,000 Annually: <a href="https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm" target="_blank">https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm(link is external)</a></li>
|
||
<li>Article: FDA moves quickly to approve easy-to-use nasal spray to treat opioid overdose: <a href="https://wayback.archive-it.org/7993/20180125101447/https:/www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm473505.htm" target="_blank">https://wayback.archive-it.org/7993/20180125101447/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm473505.htm</a></li>
|
||
<li> Article: FDA Approves First Over-the-Counter Naloxone Nasal Spray: <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray">https://www.fda.gov/news-events/press-announcements/fda-approves-first-over-counter-naloxone-nasal-spray</a></li>
|
||
<li> Article: FDA Approves Second Over-the-Counter Naloxone Nasal Spray Product: <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-second-over-counter-naloxone-nasal-spray-product">https://www.fda.gov/news-events/press-announcements/fda-approves-second-over-counter-naloxone-nasal-spray-product</a></li>
|
||
<li>Article: FDA Approves Prescription Nasal Spray to Reverse Opioid Overdose: <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-prescription-nasal-spray-reverse-opioid-overdose">https://www.fda.gov/news-events/press-announcements/fda-approves-prescription-nasal-spray-reverse-opioid-overdose</a></li>
|
||
</ol>
|
||
|
||
<h3>Tobacco Smoking</h3>
|
||
|
||
<ol>
|
||
<li>Tobacco Policy Viewer: <a href="https://gis.cancer.gov/tobaccopolicy/">https://gis.cancer.gov/tobaccopolicy/</a></li>
|
||
<li>Calo WA, et al. <em>Curr Cardiovasc Risk Rep</em>. 2013;7(6):446-452. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/24634706/">24634706</a>.</li>
|
||
<li>National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/24455788/">24455788</a>.</li>
|
||
<li>Smoking Cessation: Fast Facts: <a href="https://www.cdc.gov/tobacco/php/data-statistics/smoking-cessation/index.html">https://www.cdc.gov/tobacco/php/data-statistics/smoking-cessation/index.html</a></li>
|
||
</ol>
|
||
|
||
<h3>E-Cigarettes</h3>
|
||
|
||
<ol>
|
||
<li>Enforcement Priorities for Electronic Nicotine Delivery Systems (ENDS) and Other Deemed Products on the Market Without Premarket Authorization: Guidance for Industry: <a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-priorities-electronic-nicotine-delivery-system-ends-and-other-deemed-products-market">https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-priorities-electronic-nicotine-delivery-system-ends-and-other-deemed-products-market</a></li>
|
||
<li>Rostron BL, et al. <em>Am J Health Behav</em>. 2020;44(1):76-81. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31783934/">31783934</a>.</li>
|
||
<li>Leventhal AM, et al. <em>JAMA.</em> 2019;322(21):2132-2134. PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31688891/">31688891</a>.</li>
|
||
<li>Article: Study: Surge of teen vaping levels off, but remains high as of early 2020: <a href="https://www.drugabuse.gov/news-events/news-releases/2020/12/study-surge-of-teen-vaping-levels-off-but-remains-high-as-of-early-2020">https://www.drugabuse.gov/news-events/news-releases/2020/12/study-surge-of-teen-vaping-levels-off-but-remains-high-as-of-early-2020</a></li>
|
||
</ol>
|
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