If the consumption of these drugs is not controlled, it is estimated that there will be more than 1.2 million additional overdose deaths of opioids in North America by 2029 and that the epidemic will expand globally
The next global pandemic might not be caused by a virus or a bacterium, but by a family of drugs that are especially consumed in North America: opioids.
According to a report published in The Lancet, by 2029 there will be more than 1.2 million additional deaths from opioid overdose in North America. The document, drawn up by a committee of international experts, provides that the epidemic will spread worldwide.
The analysis shows that the year 2020 was the deadliest to date for opioid deaths in North America, with more than 76,000 deaths.
In addition, the Covid-19 pandemic has both exacerbated and overshadowed the opioid epidemic by limiting access to health services for those with opioid use disorders, overwhelming health care systems, and creating stressors such as unemployment, disability, and loss of loved ones that can lead to increased drug use and addiction.
“During the past quarter century, the opioid epidemic has claimed nearly 600,000 lives and has triggered a cascade of public health catastrophes such as disability, family breakdown, unemployment, etc. in North America. If no action is taken, by the end of this decade we expect the number of deaths to be double what it has been in the last 20 years, with a total of more than 1.2 million overdose deaths by 2029», says the president of the Commission that has prepared this document, Keith Humphreys, from Stanford University (USA).
The opioid epidemic is a public health crisis that has been developing for decades, and it could take at least that long to resolve. The health care crisis began in the 1990s when lawmakers and health care systems they failed to stop the aggressive impulse of the pharmaceutical industry to increase the prescription of opiates.
The paper’s authors say that to save lives and reduce suffering immediately, there is an urgent need to devise a cohesive public health strategy in the long term that can restrict and, ultimately, overcome the powerful influence of the pharmaceutical industry on health systems.
Opioids are an important class of analgesics prescribed for years, mainly after surgery, in palliative care and cancer pain management. But in some countries, as the US or Canada, are prescribed for many other chronic conditions ranging from low back pain to headaches to ankle sprains.
The situation in Spain is not the same as in the US, but the fact that in the last 10 years the number of people who consume these drugs has doubled, it has gone from 10,000 consumers in 2010 to more than 20,000 in 2021, according to the Spanish Medicines Agency (Aemps), and that a recently published OECD report highlighted that the opioid crisis is a complex public health problem that requires a comprehensive approach in all sectors, including services social, health and law, has made the Ministry of Health have imposed a special control for these drugs in the new Opioid Plan.
However, without proper supervision or alternative methods of pain relief, millions of people have become addicted to prescription opioids and then to other synthetic opioids and illicit drugs, such as heroin and fentanyl, which have caused hundreds of thousands of fatal overdoses.
The authors of the Commission attribute the opiate epidemic to the profit motive of the pharmaceutical industry, but also to disastrous regulatory mistakes from the US Food and Drug Administration (FDA), and other administrations.
This lack of oversight has led to a significant increase in prescriptions for opioids since 1999 and represented an earthquake in the medical practice of pain management.
“Our analysis clearly establishes how the lack of effective regulation and unchecked profit motives created the opioid epidemic,” said Howard Koh of the Harvard TH Chan School of Public Health. To ensure that safeguards are in place to curb the opioid addiction epidemic and prevent future ones involving other addictive drugs, he adds, we must end the pharmaceutical and health care industry’s undue influence on government and its unregulated push for the use of opioids. This includes isolating the medical community from the influence of pharmaceutical companies and closing the constant revolving door between regulators and industry.”
The authors further warn that the opioid epidemic is will expand globally without these measures.
The report warns that pharmaceutical companies must be prevented from exporting their aggressive opioid promotion practices abroad, as the tobacco industry when he was subject to stricter regulation in the US.
Several countries outside of North America, such as the Netherlands, Iceland, England, Brazil, and Australia, have already experienced a sharp rise in prescription of opioids. For example, between 2009 and 2015, prescriptions for opioids in Brazil increased by 465%.
The Commission recognizes that opioids are essentials from a medical point of view, but at the same time dangerous, which calls for a nuanced approach to pain management.
“Opioids should not be seen as good or bad, but as a class of drugs. essential medications for pain management. However, they carry serious risks, some of which can be difficult to recognize. This is especially the case when high doses are prescribed,” he says. David Juurlink, from the University of Toronto (Canada).
Humphreys believes that “ending the opioid epidemic in North America and preventing its global spread is a bold but achievable goal. It requires a dramatic change in policy and culture where innovation, collaboration and regulation are encouraged. we cans save and improve lives by marshalling the necessary resources and political will to eliminate the sources of addiction and boldly implement policies that maximize efforts to treat it.”
In an editorial the editors of The Lancet write that “…the moral of the opioid crisis is not that it can happen in North America. If misleading marketing and prescription practices and international funding of subsidized generic morphine for low-income countries are not checked, the possibility remains that other opioid crises occur».
Furthermore, he adds, “the risk of global spread it is greatest where Covid-19 has devastated health systems, where pain needs in resource-limited settings go unmet, and where corporations seek new markets but are allowed to self-regulate. To manage pain, you must also manage greed.”