The increasing mortality rate from opioid overdose is a major global challenge. High-, middle-, and low-income countries are affected, although the situation in North America is particularly striking. In the USA alone, >100,000 people die from opioid overdose annually, up from <20,000 deaths per annum at the turn of the century, despite a mortality decrease in 2025. Similar disturbing trends are observed in Canada. The increased use of opioids, both medically prescribed and illicitly sourced, has social, moral, and medical angles, and opinions differ between experts and within society about the relative importance of these perspectives. Whatever this balance may be, the opioid overdose situation is unquestionably a medical emergency. Medical researchers need to apply science to its fullest extent to understand the nature of overdoses and the causes of fatal outcomes, and to identify potential intervention opportunities. Have researchers, funders and the wider society allowed their ambivalence or disapproval of the drug-taking behavior to stand in the way of this necessary scientific study? There is ‘undone science’ that urgently needs to be done.
