Over the past few years, Canada and the United States have been experiencing an opioid crisis as a result of problematic opioid use fueled by the emergence of synthetic opioids such as fentanyl and carfentanil. Problematic opioid use is also spreading in other OECD countries, due to the upward trend of prescription opioid use and the complexities of the illegal drug supply. This report presents evidence on the magnitude of problematic opioid use across OECD countries, describes the main drivers, and identifies a set of policy actions to address them. The report highlights the opioid crisis as a complex public health issue that requires a comprehensive approach across all sectors, including health, social services, and law enforcement.