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Stanford University School of Medicine

United States opioid crisis serves as a warning to the world

Writing recently in The Lancet, Stanford's Keith Humphreys, PhD, shines a spotlight on the expanding globalization of the opioid epidemic. He urges leaders in other nations to learn from the United States’ mistakes and take immediate action to prevent an international crisis.

Humphreys cites sobering statistics showing more than 530,000 Americans died from drug overdoses between 2001 and 2015. “The USA was an ideal environment for opioid prescribing to explode and thereby produce an epidemic of overdose and addiction,” he writes, describing the cultural, legal and industry-based forces that fueled the crisis.

Of particular relevance to other nations is the role that some opioid drug manufacturers have played in the spread of opioid use, he said. In the piece, Humphreys discusses how opioid drug manufacturers — responding to physicians’ concerns about the poor management of chronic pain — began marketing their products as effective, low-risk medications in the 1990s.

Humphreys calls out particular pharmaceutical companies including Purdue Pharma and Mundipharma International for engaging in deceptive practices such as understating the addiction risk of their opioid products. With the U.S. taking steps to curtail the issue of excessive opioid use, drug manufacturers like Mundipharma are likely to continue efforts to further expand sales internationally, Humphreys writes.

“The rest of the world needs to be ready,” Humphreys told me.

Already, Canada is beginning to struggle with the spread of opioids, Humphreys wrote, but opioid use in the U.S. still far exceeds that of other nations.

A global Opioid Atlas created by students and researchers with Stanford Stats for Good in collaboration with the organization Global Oncology provides an interactive tool for exploring and visualizing the extreme geographic variability of opioid consumption around the world.

The Opioid Atlas is one of many initiatives being driven by the global oncology and palliative care working group led by Ami Bhatt, MD, PhD, assistant professor of medicine and genetics, and director of global oncology for Stanford Global Health.

This work demonstrates the urgent need to expand global access to effective pain medications, but as Humphreys reminds us, it remains critical that countries put appropriate safeguards in place to prevent the globalization of opioid addiction.

Previously: A look at the pros and cons of abuse-deterrent opioids, Helping patients with chronic pain during an opioid crisis and Stanford pain expert has advice for pharmacists on how to curtail the opioid crisis
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