In the discussion on “Back to School,” film # 12 in the LIFE before Death series, the recent BMJ articles quoting Dr Volkow, the Director of the USA National Institute for Drug Abuse (NIDA) were referenced. This question in particular stands out.
“I think it poses the question, why do we have much greater need of opioid analgesics than other countries, and it’s tricky because you don’t want patients not to be able to get access to their medications because there’s not sufficient quantities but at the same time, the greater the amount of drugs out there available, the greater the likelihood that they are being diverted, the greater the likelihood that people become addicted or overdosed.”
So does the USA have a greater need of opioid analgesics than other countries?
It may be worthwhile looking at USA opioid consumption provided to PPSG from the International Narcotic Control Board and displayed at our web site (http://www.painpolicy.wisc.edu) using Gapminder software. I have created some charts below comparing the USA, Australia, Ireland and Austria below.
- Much of the world’s population have access to little or no opioids for pain relief
- Country with lines: USA (Blue), Australia (Orange), Ireland and Austria (Green)
- Units are years on the X-axis and mg/person/year on the Y-axis
- Morphine equivalents are calculated for 6 opioids: morphine, oxycodone, hydromorphone, fentanyl, pethidine (demerol) and methadone.
- Morphine equivalents are calculated from a WHO formula
- Methadone is used for the treatment of opioid dependency syndrome and pain in the USA. It is primarily used for opioid dependency syndrome in most other countries.
- The United Kingdom uses significant quantities of diacetomorphine for pain control which is not reflected in this data
- Austria uses morphine for the treatment of opioid dependency syndrome.
- Canada is the smaller blue circle seen in the vicinity of the USA (reflective of population not size)