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U.S. Prescription Opioid Consumption Still Leads the World
I frequently hear the claim that “doctors have just stopped prescribing opioids”. The truth is that U.S. doctors prescribe fewer opioids than they did 5 years ago, but the U.S. still dwarfs the world in its per capita prescribing even among the heaviest prescribing nations. For details, see my latest piece at The Washington Monthly.
Author: Keith Humphreys
Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.
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5 thoughts on “U.S. Prescription Opioid Consumption Still Leads the World”
What I find appalling in the recent reports is how the DEA mostly failed to respond to high levels of opioids their records showed being delivered to certain states, cities and towns. It appears that DEA focuses huge resources on illegal drugs like cannabis and LSD, and dropped the ball on the deadly stuff. Now of course the problem is compounded by addicts turning to drugs adulterated with highly variable content of deadly fentanyl. It’s not clear at all how much of the overdose problem is due to the high level of opioid prescriptions per se.
One of the realities of drug policy is that once a drug is legalized, the ability of its producers to thwart law enforcement goes up substantially. DEA in fact tried hard to stop all this, and the companies concerned used their wealth and political influence to shut DEA down. This sad tale is related in a very nice Washington Post/60 minutes series of stories.
There are four advanced countries with prescription opioid usage at least half of the US rate: Germany, Canada, Austria and Belgium. For each of these you can find another rich country with a very similar health care system and much lower usage. So it’s not the system that accounts for the differences, still less objective need. But SFIK there is no epidemic of addiction and abuse in this high-usage group (Keith please correct me if I’m wrong). That difference with the USA is down to the latter’s system, or lack of one.
The two countries that led the world for the past 15 years were the U.S. and Canada, both of which have opioid epidemics. Hence all the US-specific explanations of the epidemic (If only we had universal health care, less inequality, more addiction treatment etc.)- are overlooking Canada’s situation.
Germany has just recently crept into the number 2 spot as you can see, but doesn’t have an opioid epidemic. Some colleagues and I are working on a short piece that examines why that is. I will try to remember to post a link to it when we are done.
Thanks for the correction on Canada. On Germany, it might be worth following up my puzzle on why German opioid prescription is twice that in France, with a similar Bismarckian health insurance system. Similarly, Denmark has twice the rate in Finland, both with NHS-type systems.
What I find appalling in the recent reports is how the DEA mostly failed to respond to high levels of opioids their records showed being delivered to certain states, cities and towns. It appears that DEA focuses huge resources on illegal drugs like cannabis and LSD, and dropped the ball on the deadly stuff. Now of course the problem is compounded by addicts turning to drugs adulterated with highly variable content of deadly fentanyl. It’s not clear at all how much of the overdose problem is due to the high level of opioid prescriptions per se.
One of the realities of drug policy is that once a drug is legalized, the ability of its producers to thwart law enforcement goes up substantially. DEA in fact tried hard to stop all this, and the companies concerned used their wealth and political influence to shut DEA down. This sad tale is related in a very nice Washington Post/60 minutes series of stories.
There are four advanced countries with prescription opioid usage at least half of the US rate: Germany, Canada, Austria and Belgium. For each of these you can find another rich country with a very similar health care system and much lower usage. So it’s not the system that accounts for the differences, still less objective need. But SFIK there is no epidemic of addiction and abuse in this high-usage group (Keith please correct me if I’m wrong). That difference with the USA is down to the latter’s system, or lack of one.
The two countries that led the world for the past 15 years were the U.S. and Canada, both of which have opioid epidemics. Hence all the US-specific explanations of the epidemic (If only we had universal health care, less inequality, more addiction treatment etc.)- are overlooking Canada’s situation.
Germany has just recently crept into the number 2 spot as you can see, but doesn’t have an opioid epidemic. Some colleagues and I are working on a short piece that examines why that is. I will try to remember to post a link to it when we are done.
Thanks for the correction on Canada. On Germany, it might be worth following up my puzzle on why German opioid prescription is twice that in France, with a similar Bismarckian health insurance system. Similarly, Denmark has twice the rate in Finland, both with NHS-type systems.