Addiction is widely misunderstood by the public and by many healthcare providers. It is not taught in most medical schools.  Combating the opioid epidemic will require providers to understand Opioid Use Disorder (OUD) and its treatment. Addiction is a chronic, relapsing disease with extraordinarily high morbidity and mortality. It is the transition from controlled to impulsive and compulsive drug intake. Physiologic dependence is just one aspect of addiction. The behavioral and social derangements seen in addiction are the major source of harm for people with substance use disorders. Addiction is not a personal failure of will. The role of genetics and environment are enormous.  It is more useful to think of addiction as a kind of “brain failure.” Dopamine and different dopaminergic systems are severely affected by drug use, resulting in chronic changes and even death to areas of the brain.  We do not  stigmatize patients with diabetes or CHF for life choices contributing to their disease, nor do we refuse them care or make their care conditional on their behavior. We treat them.  Opioid use disorder is a treatable disease. It is time that ED providers start treating it. Click HERE for more information