The reason why we use most of the world’s supply of pain meds

Anti-drug advocates often quote the statistics regarding how much of the world’s supply of opioids are used in the U.S., which artificially inflates the problem.  The real truth is that a large portion of the rest of the world is more anti-drug than the U.S., and many countries don’t prescribe pain medications at all, even for cancer or end-of-life care.

(2010) Access to pain treatment as a human right

According to international human rights law, countries have to provide pain treatment medications as part of their core obligations under the right to health; failure to take reasonable steps to ensure that people who suffer pain have access to adequate pain treatment may result in the violation of the obligation to protect against cruel, inhuman and degrading treatment.

America is actually number two in terms of per capita consumption of opioid pain medication (measured by dose equivalence between the various opioids)—contrary to recent CDC claims citing old data; these days Canada wears the crown. Canadians take 812 mg of morphine equivalents per capita, compared to 748 for the US. Other high-consuming countries include Denmark and Australia.

But high per capita consumption for pain treatment doesn’t automatically translate into high rates of misuse and addiction. Canada has an annual prevalence of prescription opioid misuse of 1%; the rate for the US, as noted above, is just over five times that, despite our lower levels of medical use.

Another important fact to note about our elevated levels of medical opioid use is that it comes in the context of extremely low levels of use in the rest of the world. Around two-thirds of the world’s population live in countries where even if you are dying of cancer, strong opioids are basically unavailable. Only 7% of the global population is believed to have adequate access to appropriate pain relief, according to the World Health Organization. Compare that to the US, which has only 5% of the world’s population but consumes 80% of its opioids. We surely overprescribe in some cases—but everyone else’s cruel under-prescribing needs to be taken into account, too.

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