Nature Outlook |


They obliterate pain. They make people feel temporarily blissful. Known as opioids, these drugs have also destroyed lives and blighted communities.

This Nature Outlook is editorially independent, produced with financial support from a third party. About this content.


Escaping the drug crisis.

Outlook | | Nature

The opioid crisis is now an epidemic that involves both prescribed and illicit drugs. Tackling it is more urgent than ever.

Outlook | | Nature

Fresh strategies and targets for chronic pain could deliver much needed replacements for opioid-based painkillers.

Outlook | | Nature

A harrowing medical experience gave Travis N. Rieder more insight than he would have wished for into how people end up hooked on opioids.

Outlook | | Nature

Ideally, opioid addiction could be prevented altogether. But failing that, strategies to make drug use safer can curb opioid-related death.

Outlook | | Nature

Highlights from laboratory studies and clinical trials on opioids.

Outlook | | Nature

More from Nature Research

μ opioid receptors (MORs) expressed on primary afferent nociceptor neurons are responsible for two maladaptive side-effects of chronic opioid use: opioid tolerance and opioid-induced hyperalgesia (pain). A combination therapy of opioid receptor agonism plus peripheral-restricted MOR antagonism abrogates these side-effects while preserving opioid analgesia in rodent models of peri-operative and chronic pain.

Article | | Nature Medicine

Two new studies show that mechanisms mediating the opioid side effects of tolerance, hyperalgesia and physical dependence are mediated spinally and can be dissociated from analgesia. These side effects can be selectively targeted by clinically available drugs without affecting their pain-relieving effects.

News & Views | | Nature Medicine

Neonatal abstinence syndrome refers to the signs and symptoms in a neonate that are caused by the cessation of prenatal exposure (via placental transfer) to various substances. In particular, opioid use or misuse during pregnancy can lead to neonatal opioid withdrawal syndrome.

Primer | | Nature Reviews Disease Primers

Studies show that gut microbial dysbiosis induced by chronic opioid use is linked to central opioid tolerance. Here, we suggest that a persistent decrease in gastrointestinal motility by opioids is a primary cause of gut microbial dysbiosis and that improving gastrointestinal transit might be a strategy in preventing opioid analgesic tolerance.

Comment | | Nature Reviews Gastroenterology & Hepatology