Opioid Use in the United States

The use of opioids is widespread and common in many first-world countries and is only globally second to cancer medicines in the rate of usage. Hundreds of millions of pain prescriptions are written each year, for various reasons, and the market for opioids is around $24 billion, an astronomical amount. While you would think that this number would be distributed throughout the world, it’s unfortunately mostly concentrated in the United States. This number works out to around 80 percent of opioids being used in the United States.

Lack of limitations

One of the reasons that the United States leads with the amount of opioids prescribed and used is likely the past lack of limitations on the drug. Previously, people who used opioids for pain relief were easily able to get multiple prescriptions from different doctors or have prescriptions renewed before they should be in an effort to take more medications. Another difference between the United States and other countries in opioid prescription is medical culture.  American doctors were much more willing to prescribe the pills for people suffering from acute and chronic pain. In other countries, opioids are only prescribed in extreme trauma cases, like childbirth, severe burns, and end-of-life care. Studying in Europe it was rather rare to see patients ask or receive the various potent opioids inappropriately.  Conversely, when I started my training nearly ten years ago the culture was to liberally give out opioids at the slightest whimper.  Since U.S. doctors were more willing to prescribe opioids, less serious medical conditions were and sometimes are treated with opioids.  Only now is the pendulum swinging the other way and there have been new regulations limiting opioid prescribing.  

Amount of prescriptions

According to the American Society of Addiction Medicine (ASAM), a number of opioids prescribed has quadrupled, with close to 300 million prescriptions written in 2012, “which is enough to provide every American adult with a bottle of opioid pills”. Not every American adult has a bottle of opioids, which is even more concerning because it means that others have lots of different opioids they’re constantly taking. While it may be still fairly easy to acquire a prescription from a doctor, many people also receive their opioids from family members or friends who have their own prescription.

High risk of addiction

Opioids whether legal or illegal can be extremely addicting, which is why it’s so concerning at the rate they’re being used in the United States.  In this document, ASAM breaks down a lot of the numbers associated with opioid use and addiction. People are willing to share pain medication, especially when they receive it for less serious medical conditions and then end up having pills or prescriptions left over that they can give to loved ones suffering from chronic pain, or to sell. Unfortunately, opioids are also a gateway to heroin usage. Many people initially start taking opioids and then work their way up to heroin, because they’ve become addicted to their prescription pills and need to get that high. It’s important to limit, or at least carefully monitor, the amount of opioids being consumed in the United States.