Thursday, May 16, 2019

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Ireland is near the top of the table of 25 countries for opioid-related drug deaths, according to new research.

The study by the Organisation for Economic Cooperation and Development shows Ireland has the sixth highest number of such deaths, with the number of fatalities increasing in recent years.

Opioid deaths include both illegal drugs like heroin, legally supplied substitute drugs such as methadone, and prescription painkillers, such as oxycodone.

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The report shows:

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[item]Ireland had 44 opioid-related deaths per million inhabitants in 2016, compared to 41 in 2011;[/item]

[item]Ireland is sixth out of the 25 countries surveyed;[/item]

[item]The rate in Ireland compares to an OECD average of 26 per million[/item]

[item]The US has the highest rate with 131 deaths per million – increasing massively from 74 in 2011;[/item]

[item]The next highest are Estonia (91), Canada (85), Sweden (55) and Norway (49)[/item]

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In 25 OECD countries for which data are available, the average of opioid-related deaths (ORD) has increased by more than 20% in 2011-2016, with the rise most pronounced in the United States, Canada, Sweden, Ireland and England and Wales.

It said the “surge” in such deaths was fuelled by a “mounting health and social crisis” leading to illegal drugs use, such as heroin, but that over-prescription of opioid pain killers by doctors had also contributed.

The report said the average availability of prescription analgesic opioids had grown steadily in the past 15 years across the OECD.

“There was a boom in the last decade,” the report said. It said opioid overprescribing was “considered one of the most important root causes of the crisis” in the US and Canada.

It said:

The influence of pharmaceutical manufacturers on pain management has been considered significant, by conducting marketing campaigns targeted mainly at physicians and patients, downplaying the problematic effect of opioids

But it said higher rates of opioids availability are “not necessarily correlated with higher overdose death rates”, citing the experience of Germany, Austria, Belgium and Denmark.

The report said that the availability of these prescribed opioid pain killers in Ireland was less than the OECD average.

In terms of illegal drugs, heroin was the “most prevalent illicit opioid worldwide” but added that fentanyl, which it described as “highly toxic”, had become “more prominent” in the market.

Fentanyl was linked to five deaths in Dublin and Cork in 2016.

“A minuscule amount of pure fentanyl (about the size of a pinch of salt) can be fatal,” said the report.

It said “economic and social conditions” such as unemployment, housing and exclusion were linked to the opioid crisis.

It recommended countries engage in better prescribing practices, expanding treatment and harm minimisation, better approaches across the health, social and criminal justice systems and more research.

It said drug consumption rooms are available in seven countries studied. It said decriminalisation of possession of illicit opioids was practised in part or full in 14 of the 25 countries studies.

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