Asian or Pacific Islanders (0.35%), and Hispanics (0.39%).
Among individuals in the United States ages 12–17 years, the overall 12-month prev-
alence of opioid use disorder in the community population is approximately 1.0%, but the
prevalence of heroin use disorder is less than 0.1%. By contrast, analgesic use disorder is
prevalent in about 1.0% of those ages 12–17 years, speaking to the importance of opioid an-
algesics as a group of substances with significant health consequences.
The 12-month prevalence of problem opioid use in European countries in the commu-
nity population ages 15–64 years is betwee n 0.1% and 0.8%. The average prevalence of
problem opioid use in the European Unio n and Norway is between 0.36% and 0.44%.
Development and Course
Opioid use disorder can begin at any age, bu t problems associated with opioid use are
most commonly first observed in the late teens or early 20s. Once opioid use disorder
develops, it usually continues over a period of many years,  even though brief periods of
abstinence are frequent. In treated populati ons, relapse following abstinence is common.
Even though relapses do occur, and while so me long-term mortality rates may be as high
as 2% per year, about 20%–30% of individuals with opioid use disorder achieve long-term
abstinence. An exception concerns that of military service perso nnel who became depen-
dent on opioids in Vietnam; over 90% of this population who had been dependent on opi-
oids during deployment in Vietnam achieved  abstinence after they returned, but they
experienced increased rates of alcohol or amph etamine use disorder as  well as increased