Opioid use disorder (OUD) continues to be one of the biggest public health challenges of recent history. The early years saw primarily prescription painkiller misuse. Now, however, as the statistics relate, many OUD patients have moved to heroin. With this move, there has been a significant uptick in the use of methamphetamines as well. This presentation with discuss the confluence of factors that led up to the epidemic and its presentation, with a focus on the related changes in OUD patients and the treatment challenges these changes present. Data collected from a nationwide network of treatment centers will be presented, and treatment implications for this changing population will be reviewed.

Objectives:
- Define changes in the opioid use disorder patients entering treatment over the past 10 years.
- Understand the relevant data collection standards and evaluate the reliability and validity of data presented based on these standards.
- Discuss implications for treatment.