Opioid Epidemic

The opioid crisis is responsible for the first three-year decline in national life expectancy in a century. The rising number of overdoses involving opioids and other substances demands a comprehensive response. This response should include policy based in evidence and public health strategies that prevent addiction, address structural factors that contribute to misuse, improve the safety and health of people who use drugs through harm reduction strategies, and boost access to effective treatments such as medications for opioid use disorder.

Johns Hopkins experts from across multiple disciplines are continually collaborating with local, state and federal officials on identifying and deploying the best evidence-based policies to support effective treatment, harm reduction, and anti-overdose strategies.

Featured Experts

  • Caleb Alexander

    Professor of Epidemiology and Medicine

    Caleb Alexander is the founding co-Director of the Center for Drug Safety and Effectiveness. He is a practicing general internist and pharmacoepidemiologist and is internationally recognized for his research examining prescription drug utilization, safety and effectiveness. See full profile

  • Joshua Sharfstein

    Director, Bloomberg American Health Initiative

    Joshua Sharfstein is a veteran public health policy leader across all levels of government—from City Hall to the White House. He has served as health policy advisor for U.S. Rep. Henry A. Waxman, Baltimore’s health commissioner, Maryland’s health secretary, and principal deputy commissioner at the U.S. Food and Drug Administration. See full profile

Related Research

Report: Life expectancy is declining in the U.S., but it doesn’t have to be

The U.S. is experiencing its sharpest decline in life expectancy in more than a century—since the eras of World War I and the Great Influenza.

This dire development represents the combined toll of many crises—but it can be reversed, according to a report released by the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health.

Until 2014, life expectancy at birth in the U.S—a core measure of population health—was steadily trending upward. Then it plateaued. Then it dropped.

In 2021, an American was expected to live 76.1 years—down 2.8 years from the 2014 peak of 78.9 years. This backslide has erased all life expectancy gains since 1996, according to recent data from the Centers for Disease Control and Prevention.

Study identifies shortcomings in FDA evaluations of opioid drugs

Approvals of prescription opioids by the U.S. Food and Drug Administration over more than two decades have been based on evaluations in narrowly defined patient groups for which certain safety-related outcomes have been rarely systematically assessed, according to a new analysis from researchers at the Johns Hopkins Bloomberg School of Public Health.

For their study, published online in the Annals of Internal Medicine, the researchers examined clinical trial data provided by manufacturers to the FDA for all new opioid applications approved by the agency between 1997 and 2018 and found that for products labeled for the treatment of chronic pain, no trials lasted for longer than three months. These trials often excluded patients who could not tolerate the drugs and failed to systematically assess some important and well known opioid-related adverse events.

Document archive shows how fentanyl promotion helped drive opioid epidemic

The University of California, San Francisco, and Johns Hopkins University expanded the UCSF-JHU Opioid Industry Documents Archive, adding one million pages of records from Insys Therapeutics—which manufactured and marketed the fentanyl spray Subsys.

The documents stem from litigation against the Arizona-based company, which specialized in drugs to treat cancer pain. Subsys, a fast-acting and highly potent opioid painkiller, had been approved by the FDA only to treat pain in cancer patients already receiving around-the-clock opioid therapy.

The Opioid Archive records released—about 760,000 documents, mostly emails—show that Insys improperly sold vast amounts of its addictive product for off-label uses like non-cancer neck and back pain. The documents also bring to light how the company pressured doctors and deployed deceptive marketing to increase sales and earn millions of dollars in profits.

Public health leaders outline steps for urgent action on opioids

A group of experts, led by researchers at the Johns Hopkins Bloomberg School of Public Health in collaboration with the Clinton Foundation, today issued a new report with comprehensive recommendations aimed at stemming the opioid epidemic, a spiraling crisis that kills on average 90 people a day in the United States and shows few signs of reversing.

The report, “The Opioid Epidemic: From Evidence to Impact,” maps out a blueprint for national action and details dozens of concrete, evidence-based steps for everyone working to fight the opioid crisis in America. The report and recommendations were prepared by researchers at the Bloomberg School’s Center for Drug Safety and Effectiveness and its Center for Injury Research and Policy, in collaboration with the Clinton Health Matters Initiative of the Clinton Foundation. The report includes an introduction by former President Bill Clinton, founder and board chair of the Clinton Foundation.

Johns Hopkins helps launch digital archive of opioid industry documents

Johns Hopkins University and the University of California, San Francisco, announced the launch of the Opioid Industry Documents Archive, a digital repository of publicly disclosed documents from recent judgments, settlements, and ongoing lawsuits concerning the opioid crisis.

The documents come from government litigation against pharmaceutical companies, including opioid manufacturers and distributors related to their contributions to the deadly epidemic, as well as litigation taking place in federal court on behalf of thousands of cities and counties in the United States. The documents in the archive include emails, memos, presentations, sales reports, budgets, audit reports, Drug Enforcement Administration briefings, meeting agendas and minutes, expert witness reports, and depositions of drug company executives.

The Opioid Industry Documents Archive leverages extraordinary expertise within UCSF and Johns Hopkins University in library science, information technology, and digital archiving. It also relies on scholarship focused on many dimensions of the opioid epidemic, ranging from the history of medicine to pharmaceutical policy to clinical care. Key organizations at UCSF involved include the Philip R. Lee Institute for Health Policy Studies; Department of Clinical Pharmacy; Department of Humanities and Social Sciences; Department of Family and Community Medicine; and Library. From Johns Hopkins University, the project involves the Bloomberg School of Public Health’s Center for Drug Safety and EffectivenessWelch Medical LibraryInstitute of the History of Medicine; and Sheridan Libraries’ Digital Research and Curation Center.

five experts convene in zoom meeting to discuss the opioid epidemic
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Expert briefing: Efforts to Combat the Opioid Epidemic

Johns Hopkins experts discuss the treatments, harm reduction strategies and emergency department policies for people experiencing opioid use disorder.