The Pain & Policy Studies Group (PPSG) is pleased to announce its annual release of new and updated global, regional, and national consumption data for Fentanyl, Hydromorphone, Methadone, Morphine, Oxycodone, and Pethidine. Additionally, the morphine equivalence data on the global, regional and all country profile pages has been updated with the 2009 data as well as the opioid consumption maps and inter active charts.
For more than 10 years, the PPSG has received opioid consumption data from the International Narcotics Control Board (INCB) and we are tremendously grateful to INCB for their willingness to again share with PPSG these raw data for 2009.
In many respects, these data are unique in that they are reported by governments to the INCB. These data represent the annual amount of opioids distributed within a country to the retail level (i.e., hospitals, hospice programs, community pharmacies, etc.). So, they do not necessarily represent the amount of opioids being prescribed, dispensed or used by patients, but still are an important indicator of availability of opioids within a country.
What do the 2009 data tell us?
As has been the case for many years, the 2009 INCB data illustrate the continuing disparities in morphine consumption between high and low- and middle-income countries (as shown by the graphic above):
- high-income countries (as defined by the World Bank income-level classification) accounted for nearly 93% of medical morphine consumed in the world, but comprised only 17% of the total population. In contrast, low- and middle-income countries, representing the remaining 83% of the world’s population, consumed a mere 7% of the total morphine consumption.
- In 2009, there was a large and striking difference between the lowest amount of morphine consumed in a country (Niger: 0.0004 mg/person) and the highest amount (Canada*76.75 mg/person)
- [*Austria reported 177.13 mg/person of morphine in 2009, but uses morphine for opioid substitution treatment, so the second highest, Canada, is listed]
- 56% of the countries reporting to INCB in 2009 consumed less than one milligram of morphine per person
But, there is hope…
Despite such grim statistics, there are some positive messages to be gleaned from these data. There continues to be some notable increases in opioid consumption in a few countries where International Pain Policy Fellows have been making progress to improve the availability of opioids, such as morphine.
- In Serbia, the milligram per capita consumption of morphine doubled from 2008 to 2009.
- Similarly, in Vietnam, morphine consumption has been continuously increasing since 2003. In 2009, the amount of morphine (mg/capita) consumed in Vietnam represents an eight-fold increase since 2003.
What do the data look like for your country?
- Do these data reported by your government to INCB seem consistent with what you know about opioid use in your country?
- What might explain large increases or decreases in a particular year?
- Is methadone primarily used for opioid substitution treatment in your country rather than for pain management?
While PPSG works towards developing more precise country level indicators of increased access to opioids and improved pain management, we continue to track national opioid consumption data as one important measure. We welcome your thoughts and feedback about these data.