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By Pat Anson, Editor

We hear often about the recreational or “non-medical” use of prescription drugs, particularly opioids, in the United States and Canada. But a new study published in the journal World Psychiatry suggests the abuse and misuse of opioids is a problem around the world.

Researchers at Columbia University’s Mailman School of Public Health studied surveys of teenagers and young adults in Europe, Latin America, Asia, Middle East and the U.S.  They found that from 2000 to 2014, there was a 200 percent increase worldwide in overdose deaths due to opioids.

“Data on high school or university students from the Middle East or Arab world indicate that nonmedical use of prescription drugs warrants closer attention,” said lead author Silvia Martins, MD, associate professor of Epidemiology at Columbia University’s Mailman School of Public Health.

“In Beirut, Lebanon, past-year nonmedical use of any prescription drugs was 21.6% among private university students and 10% among high school students. In both populations, prescription opioids were the drugs most commonly used nonmedically. In Saudi Arabia, a recent school-based survey showed a lifetime prevalence of 7.2% for the nonmedical use of any prescription drug.”

The growing misuse of opioid medication in some countries comes at a time when there is less misuse in the United States. A recent large survey found that 4.8% of American high school seniors had misused an opioid pain reliever in the past year, down from a peak of 9.5% in 2004. In the past five years, misuse of opioid pain medication by American 12th graders has declined by 45 percent.

Martins and her co-author say the availability of prescription opioids can vary widely from one country to another. Societal attitudes about medications and the misconception that they are “safe” can also contribute to misuse.

“The biggest challenge is balancing a country’s need to make available prescription drugs to those in need (i.e., those with chronic pain), while simultaneously curbing diversion and nonmedical use,” Martins wrote. “Another challenge is controlling the top most reported sources of supply, including parents, doctors and friends.”

A recent DEA report said the diversion of prescription opioids in the U.S. has fallen dramatically in the last few years, with less than one percent of legally prescribed opioids being diverted. The prescribing and abuse of opioid medication is also declining, along with the number of admissions to treatment centers for painkiller addiction. Despite these trends, which are rarely reported in the mass media, overdoses from heroin and other illegal opioids are soaring.

The DEA is planning to cut the supply of opioids even further in 2017, by reducing the supply of hydrocodone and other Schedule II opioids by 25 percent or more.