A sobering new United Nations report shows that the opioid crisis has metastasized beyond U.S. borders and engulfed the globe, concluding that opioids were responsible for two-thirds of all drug deaths worldwide in 2017.
In their annual World Drug Report, the United Nations (UN) Office on Drugs and Crime found that opioid use increased in Africa, Asia, Europe and North America, and said that of the 585,000 people who died across the world in 2017 as a result of drug use, two-thirds of those cases were as a result of opioid use.
“The overdose mortality rates in the United States and Canada are high, and those countries are making considerable efforts to monitor the situation,” the report states.
“In both countries, overdose deaths are not uniformly distributed throughout the country, but are concentrated in specific regions. In Canada, the highest rates are seen in the western provinces of Alberta and British Columbia. In the United States, the highest rates are seen in Northeastern and Midwestern states,” the report reads.
Another area of opioid concern is in parts of Africa like in Nigeria, where rather than fentanyl, the bigger concern is Tramadol. The report notes that Tramadol use was second only to marijuana use in Nigeria.
Dr. Tim Brennan, the director of the Addiction Institute at Mount Sinai West/St. Luke's in New York City -- who was not involved in the creation of the new UN report -- said that Tramadol is an opioid medication that's “much weaker” than those more commonly used in the U.S., like oxycodone or codeine.
“If the Nigerians have a Tramadol problem, it’s probably because they have widespread availability of Tramadol, and not necessarily because they prefer Tramadol as a drug of choice,” Brennan said. “For example in America where there is a widespread illicit marketplace it’s actually unlikely for a patient to use Tramadol because it’s much weaker compound compared to other opioids.”
While opioid use is on the rise, the report notes that cannabis is the most commonly-used drug by far, which comes as little surprise as more and more U.S. states are legalizing its recreational use and even more have decriminalized the drug.
Yury Fedotov, the executive director at the UN Office on Drugs and Crime, wrote in the introduction to the report that while opiate trafficking from Afghanistan through Central Asia to Russia has dropped in the past decade, trafficking in fentanyl and similar drugs are expanding in Europe and elsewhere.
“The findings of this year's World Drug Report fill in and further complicate the global picture of drug challenges, underscoring the need for broader international cooperation to advance balanced and integrated health and criminal justice responses to supply and demand,” Fedotov said in a statement.
In all, the report said that of the estimated 271 million drug users worldwide, 35 million are believed to suffer from drug use disorder, which is defined as a situation where their drug use is so significant to the point that they are either drug dependent or require treatment.
The report estimates that only one in seven people with a drug use disorder is receiving adequate treatment.
Brennan said that figure was actually larger than he expected.
“I’m surprised that it’s not more like 1 in 10 or 1 in 20,” he observed.
“We have a big problem in this country and globally identifying people with substance use disorders,” he said, noting that “a lot of that is driven by stigma.”
“If there's a silver lining of the so called opioid crisis perhaps it’s that people are more comfortable than even before with talking about addiction,” he said.