The Opioid Crisis: A Global Problem

It’s not difficult to imagine the opioid crisis as an isolated problem that only exists within the United States. Drug overdose is the leading cause of death for Americans under 50, now leading firearm and motor vehicle deaths, cutting short 91 lives each day. President Trump recently labeled the opioid epidemic a “public health emergency.” This label enables the hiring of personnel needed to take on the issue, allows the expansion of telemedicine services and permits flexibility in the use of federal grant money.

It’s true – the United States remains the world leader in opioid consumption, abuse and opioid-related death, but the crisis extends well beyond our borders.

The fight against the opioid crisis is global. Countries are grappling to fight the opioid crisis within their own borders and quell issues that arise before they cause major disruption in society. Canada and the United Kingdom are two examples of countries who have witnessed the rise in opioid prescribing, consumption, and overdose deaths in recent years.

Canada

Canadians are only second to Americans in per capita consumption of opioids. The population suffers disproportionately, with the highest rates of consumption and opioid-related deaths occurring in Western Canada. According to the Canadian Centre on Substance Use and Addiction, 13.1% of Canadian adults used opioids in 2015. A report from the Canadian Institute from Health Information revealed that opioid poisonings resulted in more than 13 hospitalizations each day in 2016.

In 2016, 2,816 opioid-related deaths were reported in Canada.

The Government of Canada committed to a comprehensive approach to solving the opioid crisis in November of 2016 in the “Joint Statement of Action to Address the Opioid Crisis,” implementing a public health emergency response with specific goals focused on prevention, treatment, harm reduction, and enforcement.

In addition, Vancouver is home to the first and only safe injection site in North America, established in 2003. The site has seen no deaths from overdose in the 14 years since its inception and was visited over 10,600 times in June 2017 alone. Safe injection sites are still an issue of contention in the United States, with groups such as the American Medical Association fighting to implement them against a reluctant Congress.

United Kingdom

Reports that almost 1 in 3 of Europe’s overdose deaths occur in the UK have granted it the undesirable title of the “drug overdose capital of Europe.” Data from the National Health Service shows an increase in opioids prescribed from 12 million in 2006 to 24 million in 2016. Similarly, the region has seen a rise in prescription drug poisoning hospitalizations from 4,891 to 11,660 in the same period.

The government of the United Kingdom provides an online resource for providers and commissioners which outlines information about how drug abuse deaths can be prevented. Their recommendations include a plan for treatment, expanding the availability of naloxone, and emphasizing the need for local authorities to invest in preventing drug misuse deaths.

What is the best course of action when dealing with an opioid crisis?

It is difficult to say with certainty which approaches will be most and least effective at curbing the opioid crisis. Defensive plans focused on prevention and offensive plans focused on treatment have both proven successful, but there is much work to be done in all three countries.

Still, it’s important to consider the issues and solutions on a global level to better understand and consider new interventions that could provide a solution.

Besides the current interventions in place, it’s critical to remain vigilant in researching not only the route of the problem, but also how it can be avoided.  The use of data and analysis is imperative to continuing to build upon current and new interventions.