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Friday 1 December 2023

Opioid Crisis In Pictures

For every one million Americans, almost 50,000 doses of opioid's are taken every day.

Opioid Daily Usage 2017
Opioid Daily Usage 2017

That's around four times the rate in the UK. In the 2017, U.S physicians prescribed 47,580 daily doses of narcotics per million inhabitants. This is a high rate compared to those of other countries in the same year: Eg 16,591 daily doses in Australia and 12,058 daily doses in the United Kingdom.

We have discussed the practice of prescribing cheap opioid's, rather than trying pain management or expensive physiotherapy etc under the US medical system e.g. The town of Kermit (pop 406 .... yep, just 406), in West Virginia USA, receiving almost nine million opioid pills in just two years, in a practice known as prescription churning. 

I can confirm from personal experience that year, that the general medical practice in the UK is to try and give you very few opioid painkillers if you are getting better (I'm not discussing terminal patients) .... after major abdominal and chest area surgery, I was only allowed opioid painkillers for 5 days ..... I then just had to stiff upper lip the pain (which lasted in diminishing amounts for a further month or so), by using over the counter light pain killers such as ibuprofen and paracetamol etc .

US Opioid Addiction
US Opioid Addiction

Despite the general reluctance to prescribe opioid painkillers, the US opioid epidemic obviously led to similar concerns about doctor prescribed opioid's in the UK, with the fear that physician prescribing behaviour by General Practitioners, might be a key driver in rising opioid prescriptions, and increasing long-term opioid use in the UK as well.

NHS studies show that codeine was the most commonly prescribed opioid in the UK, with use increasing 5-fold from 2006 to 2017, reaching 2,456 prescriptions to 10,000 people per year. Of the other opioid's, morphine, buprenorphine, and oxycodone, prescribing rates continued to rise steadily throughout the same period. 

Of those on high dose, or very high dose opioid's, 10.3% and 18.7% of those identified at the start of the study period, remained in the same MME/day category or higher, at 2 years, respectively. Following opioid treatment start, 14.6% became long-term opioid users in the first year .... all suggesting that the dangers of addiction are high.

Its hard to see how to reverse the trends in any country, even when we know that they lead to addiction (with increased crime and violence usually associated with that addiction), as we don't seem willing as a society, to accept that some pain or discomfort is often part of any recovery. 

That being said, some countries have introduced tighter controls on the prescribing of these painkillers and have reduced the daily usage figures.

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