This paper provides a background to the opioid epidemic in the United States. The opioid epidemic, a public health crisis, is perceived by the public to be caused by issues in the medical field. By providing a historical background to the epidemic, this study demonstrates that the beginnings of the opioid crisis were not only rooted in past issues within the healthcare field but in previous social misconceptions about opioids. This historical backdrop is proceeded by an examination of opioid pharmacology, which discusses what opioids are, what is currently known about opioid addiction and reviews the presently used treatments for opioid use disorder. In 2010, the federal government sought to mitigate the opioid epidemic through the Patient Protection and Affordable Care Act, which included guidelines to reduce prescription opioid addiction and offered treatments for opioid use disorder. The Medicaid expansion, which was built into this law, sparked controversy; controversy about it having a potentially detrimental effect on the opioid epidemic. This study discusses the Medicaid expansion after a summary of the Patient Protection and Affordable Care Act to address this controversy. A review of the literature on this relationship between the Medicaid expansion and the epidemic suggests that the expansion both alleviated and aggravated the opioid crisis. The Medicaid expansion alleviated the crisis through increasing the access to opioid abuse treatment, but it also widened the doors to prescription opioid abuse.



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