Purpose of Review <p>This review explores the epidemiology of opioid use, misuse, and opioid use disorder (OUD), exploring its risk factors, consequences, and management strategies.</p> Recent Findings <p>The rising prevalence of synthetic opioids has significantly increased overdose deaths, with the rise of polysubstance use posing a critical problem in the current phase of the epidemic. There has also been a shift in the use of opioids, with an increasing preference for smoking over injecting. Risk factors, including genetic predisposition, socioeconomic disadvantage, and mental health disorders, are strongly linked to OUD. Management strategies, such as medications for OUD, harm reduction programs, and psychosocial interventions, have proven effective but face barriers such as stigma and limited accessibility. Emerging approaches like novel therapeutics show promise in improving outcomes.</p> Summary <p>OUD remains a complex public health challenge requiring substantial and collaborative efforts. Addressing accessibility barriers, enhancing treatment retention, and integrating innovative therapies are essential to mitigating the epidemic’s impact and reducing its burden.</p>