In support of the U.S. Department of Health and Human Services (HHS) Overdose Prevention Strategy, the Food and Drug Administration (FDA) has committed to four strategies to decrease the number of opioid deaths: supporting primary prevention; encouraging harm reduction; advancing development of evidence-based treatments for substance use disorders; and protecting the public from unapproved, diverted, or counterfeit drugs that present overdose risks. To see the FDA's Overdose Prevention Framework with links to supporting documents, go to http://www.fda.gov/drugs/drug-safety-and-availability/food-and-drug-administrati.

Primary prevention includes minimizing the risk of unnecessary initial exposure and inappropriate prolonged prescribing of drugs with abuse potential. NPs who prescribe opioids and other drugs, such as benzodiazepines or other stimulants, should review clinical guidelines on current best practice. The Centers for Disease Control and Prevention (CDC) has released new recommendations, entitled the CDC Clinical Practice Guideline for Prescribing Opioids for Pain-United States, 2022, which update and expand the 2016 guideline. To view the new guideline, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9639433/pdf/rr7103a1.pdf.

NPs can also access various online resources on the HHS Overdose Prevention Strategy page (http://www.hhs.gov/overdose-prevention/background). NPs and nurses can also help to educate the public on the risk to children, teens, and pets from unused prescription opioids kept in the house. The FDA has educational materials in its Remove the Risk toolkit, including public service announcements; posters; postcards; fact sheets; and sample drop-in content for emails, newsletters, and other outreach. These are all available free of charge, in both English and Spanish, at http://www.fda.gov/drugs/safe-disposal-medicines/safe-opioid-disposal-remove-ris.

The crisis of opioid overdose deaths in the United States continues. The CDC's National Center for Health Statistics noted in a recent press release that "there were an estimated 107,622 drug overdose deaths in the United States during 2021, an increase of nearly 15% from the 93,655 deaths estimated in 2020. The 2021 increase was half of what it was a year ago, when overdose deaths rose 30% from 2019 to 2020." Opioid use accounts for most drug overdoses. Between 1999 and 2021, deaths from synthetic opioids (excluding methadone) increased 97-fold, according to the HHS. Prescription opioid deaths have risen while heroin deaths have trended downward over recent years; when heroin is involved in an overdose death, it is usually in combination with fentanyl, according to the National Institute on Drug Abuse. The U.S. state with the highest increase in overdose deaths in 2021 was Alaska, where deaths increased by 75%. To see current U.S. data or current data for a particular state, go to http://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.