Improving Health

Substance Use

Opioid Use Disorder

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%.

Image credit: Scott Housley

  • In 2017, the opioid crisis was declared a public health emergency by HHS.
  • In 2020, drug overdose was the leading cause of death for Americans ages 18-45, and more than 2.7 million Americans had an opioid use disorder. For every fatal overdose, it is estimated that there are 10 non-fatal overdoses and 20 opioid-related hospitalizations. 
  • Buprenorphine, approved by FDA in 2002 to treat addiction to opioids, works by helping reduce withdrawal symptoms and drug craving.


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. Opioid overdose deaths decreased by 14% in states after they enacted naloxone access laws.

Image credit: National Institute on Drug Abuse, NIH

  • Between April 2020 and April 2021, over 75,000 people died of opioid overdoses.
  • In 2015, FDA approved the first naloxone nasal spray—NARCAN®—developed as a result of NIH-funded research.
  • Naloxone is now the standard treatment to reverse opioid overdose and can be used by both medical professionals and laypersons without formal training.
  • 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.

Tobacco Use

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.

Image credit: Gianandrea Villa on Unsplash

  • Smoking in U.S. adults hit an all-time low of 13.7% in 2018—down two-thirds since the U.S. Surgeon General issued a landmark report on the health consequences of smoking 50 years ago. 
  • Smoke-free policies decrease smoking rates, help to promote quitting, de-normalize tobacco use, and reduce exposure to secondhand smoke. 
  • 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.
  • NIH-funded programs provide tools and tips to the public on quitting smoking.


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.

Image credit: Drew Walker on Unsplash

  • 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. 
  • 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.
  • Data from MTF show that, prior to 2020, there were dramatic increases in teen vaping, which leveled off in 2020 and decreased in 2021.


Opioid Use Disorder

  1. Medication-Assisted Treatment for Opioid Use Disorder:
  2. Article: As Opioid Deaths Surge, Biden Team Moves To Make Buprenorphine Treatment Mainstream:,the%20country%20where%20the%20drug%20is%20rarely%20prescribed
  3. Article: Research to Address the Real-Life Challenges of Opioid Crisis:
  4. Opioid Addiction:
  5. Article: Taking Stock of NIDA’s Achievements and Looking to the Future:
  6. Larochelle MR, et al. Ann Intern Med. 2018;169(3):137-145. PMID: 29913516.
  7. National Opioids Crisis: Help and Resources:
  8. SAMHSA. 2019 National Survey of Drug Use and Health, 2020:
  9. CDC. Wide-ranging ONline Data for Epidemiologic Research, Multiple Causes of Death 1999-2022.
  10. SAMHSA. 2020 National Survey on Drug Use and Health, 2021.


  1. McClellan C, et al. Addict Behav. 2018;86:90-95. PMID: 29610001.
  2. Townsend T, et al. Int J Drug Policy. 2020;75:102536. PMID: 31439388.
  3. U.S. Surgeon General’s Advisory on Naloxone and Opioid Overdose:
  4. Article: NARCAN Nasal Spray: Life-Saving Science at NIDA:
  5. Article: Taking Stock of NIDA’s Achievements and Looking to the Future:
  6. Article: Surgeon general urges more Americans to carry overdose antidote naloxone:
  7. Article: Teaching Children How to Reverse an Overdose.
  8. Drug Overdose Deaths in the U.S. Top 100,000 Annually:
  9. Article: FDA moves quickly to approve easy-to-use nasal spray to treat opioid overdose:

Tobacco Use

  1. Tobacco Policy Viewer:
  2. Calo WA, et al. Curr Cardiovasc Risk Rep. 2013;7(6):446-452. PMID: 24634706.
  3. 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: 24455788.


  1. Enforcement Priorities for Electronic Nicotine Delivery Systems (ENDS) and Other Deemed Products on the Market Without Premarket Authorization: Guidance for Industry:
  2. Rostron BL, et al. Am J Health Behav. 2020;44(1):76-81. PMID: 31783934.
  3. Leventhal AM, et al. JAMA. 2019;322(21):2132-2134. PMID: 31688891.
  4. Article: Study: Surge of teen vaping levels off, but remains high as of early 2020:

This page last reviewed on March 1, 2023