Americans love Opioids

Been meaning for a while to link to this Wonkblog post that puts American opioid use in international context.  Based on the title of this post, you can probably figure out the deal:

United Nations data provide one important benchmark against which to judge how much more or less opioid consumption might be appropriate for a given country. And what it finds about the United States is jaw-dropping: Even when the list is restricted to the top 25 heaviest consuming countries, the United States outpaces them all in opioid use.

For example, Americans are prescribed about six times as many opioids per capita as are citizens of Portugal and France, even though those countries offer far easier access to health care. The largest disparity noted in the U.N. report concerns hydrocodone: Americans consume more than 99 percent of the world’s supply of this opioid.

There’s a lot of factors as play, but I find the cultural explanation particularly intriguing:

Cultural factors may augment U.S. opioid consumption, as well. Relative to Europeans, Americans have more faith that life is perfectible (e.g., all pain can be avoided). Consider, for example, a 55-year-old who feels acute back and leg pain after doing the workout that was easy when he was 25. A European in this situation might reflect sadly that aging and physical decay must be accepted as part of life, but an achy American might demand that his doctor fix what he sees as an avoidable problem by prescribing him opioids.

And, while I’m at it.  Just how much do addicts want their opioids?  Enough that they will crush literally hundreds of pills of loperamide (presumably known to you as Immodium A-D), which is actually an opiate (don’t worry, it doesn’t usually affect the brain unless you take hundreds).

Amusingly to me, just last week I had a pretty good bout of what I prefer to refer to as lower gastro-intestinal distress, and the loperamide was amazingly effective, as it always has been for me.  Honestly, I can think of few medications I ever take that actually do a better job of treating the condition that they are supposed to.  Anyway, I’ll stick with 1-2 at a time.

About Steve Greene
Professor of Political Science at NC State

3 Responses to Americans love Opioids

  1. R. Jenrette says:

    Are you so sure it’s the public’s fault that people get hooked on opioids? Why do doctors bow to pressure and prescribe a medication that is known to be addictive? What happened to “First, do no harm”?
    Why aren’t doctors required to disclose the risk of opioid addiction when they offer opiods? Why wouldn’t they disclose without a legal requirement? There are other pain killers available.
    Yes, intelligent people should be aware of the effects of some medications but it’s unrealistic to think that patients as a group understand these risks.
    Doctors, stop making opiods routine.

  2. ohwilleke says:

    I don’t find the analysis very insightful. Yeah, we use a lot. Yeah, we have a medical culture that disfavors unnecessary pain. But, I don’t think that the rationale is capturing the demographics or motives of the people who are using them heavily.

    You’ll get more insight into what is going on in the U.S. by reading Victorian narratives from when opiods were basically unregulated, or reading the Hillbilly Elegy, than you will reading these popular press accounts.

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