HealthSociety and CultureThe Risk Radar

July 2019: Killer painkillers

Over the past few years, the U.S. and Canada have been experiencing an opioid crisis. In 2017, approximately 11.4 million Americans misused opioids and an estimated 1.7 million individuals suffered from substance use disorders related to prescription opioid pain relievers.

Opioids are pain-reducing drugs and their name derives from the word “opium”, since many opioids such as morphine and codeine are naturally extracted from opium poppy plants. They include both legal painkillers (such as morphine) as well as illegal drugs (such as heroin). Opioids have an addictive effect on users as they often need to take increasingly larger doses of medication to maintain its effect. In many U.S. cases, users switch to heroin because it is less expensive than prescribed drugs. The National Institute on Drug Abuse estimated that in 2016, almost 50% of young people who injected heroin had turned to heroin after abusing prescription painkillers. Consequentially, from 2010 to 2017, heroin overdose deaths increased five-fold.

However, the problem is not restricted to North America. In a recent report published by the OECD, the problematic opioid use is also tracked in other leading economies, mostly due to the upward trend of prescription opioid use and the complexities of the illegal drug supply. This uptick of opioids misuse and addiction has also been observed in the Netherlands. One million Dutch people take opioids, mostly oxycodone, a rapid increase from 2010 (650.000 Dutch users). Among the causes are effective marketing of the heavy medication and the financial pressure on health care institutions to reduce costly long hospital stays and to send patients home while prescribing heavy medication. A more socio-cultural explanation is that in wealthy countries, the dominant idea is that we have the right to a life free of pain, some even argue that it is this very perspective on pain that is part of what is driving the ineffective solutions that have emerged in response to the opioid crisis.


  • Opioid dependency comes with high health care costs. In 2013 alone, the economic burden of prescription opioid overdose, abuse, and dependence in the U.S. was estimated at $78.5 billion.
  • The opioid crisis is a complex public health issue. According to the OECD report, it requires a comprehensive approach across all sectors, including health, social services, and law enforcement.


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