Is the Opioid Crisis Only an American Issue?

While the U.S. struggles to turn the tide of the opioid crisis, the country is not alone. Pain-relieving drugs are the second-largest class of pharmaceutical substances across the globe after cancer medicines.

They’re dangerously addictive, increasingly accessible, and kill far more than pain. Opioids are a class of addictive substances either derived from, or created to simulate, opium. These include legal pain relievers like morphine and oxycodone, as well as illicit drugs like heroin. Regardless of form, opioids are claiming lives at an alarming pace in the United States. But is this affliction unique to America? And if so, why?

A leader in the behavioral health care industry, The Recovery Village recently set out to answer these questions by surveying hundreds of Americans across the country, many of whom are intimately familiar with the extent of the opioid epidemic. Their responses shed light not only on the severity of the problem in the eyes of the public, but how Americans feel it needs to be addressed, and how this epidemic extends beyond U.S. borders.

Opioids Are Killing More Americans Every Day

News coverage of the United States opioid epidemic shows a country ravaged by prescription opioid deaths as more people lose family members and friends to the disease of addiction. Nearly 61 percent of The Recovery Village survey respondents say they are “very familiar” with the opiate crisis, and almost 67 percent marked it as a “big issue” in their city. The epidemic has grown to become a city-wide issue and a state-wide scourge, affecting — and claiming — lives everywhere. Of the survey respondents, 26 percent are intimately aware of the devastating effects of opioids, as they are dealing with opioid addiction within their own families.

The American Opioid Epidemic by the Numbers

• Americans consume 80 percent of the world’s opioids
• Americans consume about 99 percent of the world’s supply of hydrocodone
• More than 650,000 opioid prescriptions are dispensed every day
• From 1999–2015, 183,000 people died from prescription opioid overdoses
• In 2015, 12.5 million people misused prescription opioids
• Every year, Americans spend an average of $20 billion in ER care for opioid poisonings
• 91 Americans die every day from opioid overdoses
• Opioids are responsible for 6 out of 10 overdose deaths
• 75 percent of heroin use disorders begin with prescription opioid usage
• From 2010–2016, heroin-related deaths increased five-fold

To put the American opioid epidemic into perspective, drug overdose is now the leading cause of death for people under age 50 — but it hasn’t always been so. Before 1995, opioids were originally reserved to treat severe, cancer-related and post-surgical pain. In the late 1990s, pharmaceutical companies started increasing the supply of prescription opioids, which they falsely claimed could alleviate chronic pain without becoming addictive.

This false claim, combined with direct marketing to consumers by pharmaceutical companies, started a trend of over-prescribing opioids that has yet to slow. The number of prescription opioids sold to pharmacies, hospitals and clinicians nearly quadrupled from 1999 to 2010. In 2016, 64,000 Americans died by drug overdose. An alarming two-thirds of these deaths were attributed to opioid medications. The life-threatening nature of opioids was eventually realized by the medical community, but not early enough to quell the surge of prescriptions dispensed and deaths due to overdoses.

Who Is to Blame for the American Opioid Epidemic?

According to the National Safety Council’s recent poll, opioid addiction often begins with a prescription. The survey revealed that nearly 99 percent of physicians exceed the recommended three-day dosage limit. Dr. Debra Houry, Director of the CDC’s National Center for Injury Prevention and Control, confirms that the issue often starts in the doctor’s office. “The over-prescription of opioids for chronic, non-cancer pain outside palliative care is driving the epidemic of opioid dependency in the USA,” she said.

The Recovery Village survey respondents echo this sentiment, with 31 percent believing the main cause of the opiate crisis is due to the over-prescription of opiates and 48 percent blaming doctors directly for causing the opioid epidemic.

Forced into action by the urgency of this issue, in October of 2017, the President of the United States declared the nation’s opioid crisis a public health emergency, but few Americans think this move made any dents in the growing epidemic. When asked if they think the U.S. is doing enough to address the opiate crisis, 57 percent of The Recovery Village survey respondents said: “not at all.” This collective judgment rings true in every corner of the U.S. as no state is exempt from the opioid epidemic. All areas felt the effects of this crisis, with the five states struggling the most being West Virginia, New Hampshire, Kentucky, Ohio and Rhode Island.

But is pill-saturated America really the only nation pinned under the heel of the opioid crisis? The statistics paint a grim picture of American opioid use: although the United State’s population of 319 million accounts for only 5 percent of the world’s population, Americans consume almost 80 percent of the global opioid supply. As the overdose deaths climb every day, it’s hard to imagine that the epidemic is isolated to only the U.S. Nearly 77 percent of survey respondents believe that opiates are “definitely a worldwide problem.” Are those in the land of red, white and blue the only ones overdosing on opioids?  

Opioid Use Around the Globe 

While the U.S. struggles to turn the tide of the opioid crisis, the country is not alone. Pain-relieving drugs are the second-largest class of pharmaceutical substances across the globe after cancer medicines. Whether prescribed by a doctor or taken from a dealer, opioids are doing more harm than healing on a global level. Of all the substances tracked and studied, the latest World Drug Report from the United Nations Office on Drugs and Crime affirms that opioids currently hold the title of the most harmful class of drugs in the world. According to this report, 29.5 million adults worldwide suffered from a substance use disorder in 2015, and 35 million individuals used opiates and prescriptions opioids. The report pinpoints opioids as being responsible for a startling 70 percent of the negative health impacts involved in substance use disorders worldwide.

Global Opioid Use At a Glance

• Opioids comprise a $24 billion market
• 35 million people use opioids and opiates
• 9.2 million people use heroin
• In 2016, 6,380 tons of opium were produced
• Almost 95 percent of opioid use is in the U.S., Canada and Western Europe

Those dependent on opioids are at a stark disadvantage considering the global growth of the opioid market, which is becoming more diversified than ever. In 2016 alone, opium production across the world increased by one-third, compared with 2015, and Afghanistan was one of several countries responsible for producing 6,380 tons of opium in 2016. Global opium production, which fuels the creation of a myriad of opioids, shows no signs of slowing down.

Which Countries Consume the Most Opioids? 

While many parts of the world are seeing a rise in opiate-related deaths, there is a clear connection between affluent nations and the increased consumption of prescription opioids. Like Americans, people seeking relief for chronic pain are often prescribed opioids in other high-income countries including Great Britain, Australia and Northern Ireland. The opioid epidemic crept into Canada as well, with opioid overdose deaths increasing five-fold in Ontario between 1991 and 2014, and 2,000 Canadians dying by overdose in 2015.

Vikesh Singh, assistant professor of medicine and director of the Pancreatitis Center at Johns Hopkins University explains this phenomenon, saying, “If you include Canada and Western Europe, [consumption of global opioid supply] increases to 95 percent, so the remaining countries only have access to about 5 percent of the opioid supply.” For this tiny percent, opioid use is limited to severe cases, such as acute hospitalization, end-of-life care and for terminal illnesses.

Opioid misuse is a global scourge. But as the statistics show, the wealthier a nation is, the more connected it is to opioid use, misuse, and overdose deaths. As Americans reside in one of the most affluent nations in the world, each individual can access — and easily lose their life to — “a bottle of pills and then some,” as described by U.S. Surgeon General Vivek Murthy.

How Will the American Opioid Epidemic End?

Although the opioid epidemic isn’t a plague unique to the United States, the Land of Opportunity is overdosing on opioids at a faster pace than any other nation in the modern world. The answer to ending the American opioid epidemic might very well be a solution that’s already worked for thousands of people across the country — and around the globe.

To begin to cut back on the number of overdose deaths, the U.S. could take a page out of Portugal and Switzerland’s books. These two countries broke from the grip of serious heroin epidemics through offering increased access to opioid substitution therapy (OST) and the implementation of a four-pillar strategy that focused on prevention, treatment, repression and harm reduction. By focusing on quality care that keeps people alive, Portugal and Switzerland saw a drastic drop in overdose deaths and the increased health of all of its citizens.

Comprehensive treatment is quickly becoming the battlecry for countless Americans: parents and children as well as other family members and friends who have seen far too many loved ones claimed by the disease of addiction. In the The Recovery Village survey, 85 percent of respondents said rehab is the best solution for people addicted to opiates or opioids. Recognizing opioid addiction treatment as a dire need in the nation, many rehab centers are working to make care as affordable and accessible as possible, and The Recovery Village aims to end the opioid epidemic in America through compassionate care. With a network of facilities across the country, The Recovery Village provides a full continuum of care programs that help people understand and overcome addiction. The more treatment resources the U.S. has, the closer it will be to a future free from opioid addiction.

If you or a loved one is struggling with opioid addiction, help and healing are closer than you think. Call The Recovery Village’s opiate hotline today to speak with an associate who can answer your questions, offer advice, and guide you to a rehab center that meets your needs. Calling is toll-free, confidential and there is no pressure to commit to a program.

By – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more