Access to opioids reveals global disparities
Thursday March 31st 2022
Significant disparities exist globally when it comes to access to opioid painkillers, a new UK study shows today.
Research by UCL, London, published in the latest edition of The Lancet Public Health has found that global opioid sales increased by an estimated 4% annually from 2015 to 2019.
But while opioid use in some countries in Africa and South America was less than one tenth of 1% of the rates in wealthier countries in North America, Europe and Australia, some countries are starting to catch up. This has resulted in gradual geographic convergence in opioid consumption.
North America has seen a decline in opioid use, which has led to European countries, led by Switzerland, Germany, and Spain, surpassing the USA in opioid sales.
Lead author Dr Wallis Lau, of UCL School of Pharmacy, said: “We found that while there is some improvement in a lot of countries, there are still concerningly low rates of opioid use in large parts of the world, even in numerous middle-income countries.
“Opioids have been listed by the World Health Organization as an essential class of medicine for acute pain, cancer-related pain, and palliative care since 1977, so it is troubling that in many parts of the world, people are unable to access this medicine. There is an urgent need to tackle the global gap in opioid access.
“Some countries have low opioid analgesic consumption despite a high cancer prevalence, which could suggest inadequate access to opioid analgesics as much-needed pain control.”
The research team analysed the global pharmaceutical sales data of 66 countries or regions from the IQVIA-Multinational Integrated Data Analysis System database on opioid analgesics between 2015 and 2019.
This included both prescription and over-the-counter medications, including morphine and codeine.
They found opioid analgesic sales increased from 27.52 milligram morphine equivalent (MME) per 1,000 inhabitants per day in 2015, to 29.51 in 2019.
The highest rate was in Canada, at 988 MME per 1,000/day, a reduction from 1,581 in 2015. In the UK, the rate was 639 MME per 1,000/day, a slight decline from 2015.
A group of 12 West African countries reported 0.01 MME per 1,000/day, some other countries, including three in South America, also reported rates below 1 MME per 1,000/day.
The research team say the disparities go beyond factors such as wealth, overall healthcare network quality, or cancer rates, as there are differences in attitudes of doctors and patients towards the use of opioids.
Wealthy countries such as the United Arab Emirates and Saudi Arabia reported very low rates, at 0.79 and 1.24, respectively, while some countries, including Kazakhstan, reported low rates of opioid consumption (5.4) despite high cancer prevalence or cancer death rates.
Joint senior author Professor Ian Wong, of UCL School of Pharmacy and University of Hong Kong, said: “These findings reinforce the need to recognise palliative care and pain relief as a global public health priority. In countries that already have good access to opioid analgesics, it is important to avoid opioid misuse and overprescribing, without leaving patients undertreated.”
Ju C, Man KKC, Wang Z et al. Global, regional, and national trends in opioid analgesic consumption from 2015 to 2019: a longitudinal study. The Lancet Public Health 31 March 2022
Tags: Pain Relief | Pharmaceuticals | UK News | World Health
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