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The role of neurologists in tackling the opioid epidemic

Nature Reviews Neurology (2019) | Download Citation


The opioid crisis constitutes a public health challenge at the intersection of two interrelated medical problems — opioid addiction and chronic pain. Overlap of the reward and pain circuits in the brain underlies the frequent comorbidity of chronic pain and opioid addiction, whereas inadequate support, treatment and health-care reimbursement for both of these conditions are major contributors underlying the magnitude of the problem. Neurologists are uniquely positioned to help address the opioid crisis, not only through their involvement in the management of chronic pain conditions but also because they can screen for and manage opioid use disorders. The new NIH Helping to End Addiction Long-term (HEAL) Initiative will support research into pain and opioid use disorders to help address the opioid crisis. Neurologists’ involvement in basic, translational and clinical research is needed for the development of new pain therapeutics and biomarkers and interventions to prevent chronic pain and to prevent and treat opioid addiction.

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The authors thank R. Baler and J. Ward for their valuable editorial help with the manuscript.

Reviewer information

Nature Reviews Neurology thanks G. Fischer and other anonymous reviewer(s) for their contribution to the peer review of this work.

Author information


  1. National Institute on Drug Abuse, NIH, Bethesda, MD, USA

    • Nora D. Volkow
  2. National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA

    • Walter J. Koroshetz


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Both authors contributed equally to all aspects of the manuscript.

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The authors declare no competing interests.

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Correspondence to Nora D. Volkow.

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