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Opioids killed an estimated 47,600 people across the United States in 2017, an increase of more than 16% since 1999. In fact, in the US, an individual is now more likely to die from a prescription pain medication overdose than in a car crash.

Opioid addiction began to rise in the US at the end of the 1990s, as doctors began to prescribe pain-relieving medication to control both acute and chronic pain for issues ranging from terminal illness to small injury and surgery. At the same time, the pharmaceutical company Purdue Pharma began to falsely market their “long-acting” version of the opioid oxycodone as a safe alternative to other pain medications. Sales of OxyContin increased dramatically from $48 million in 1996, when the drug was released, to over $2.4 billion in 2012. The number of prescriptions for opioid medication increased from 112 million to a peak of 282 million in 2012.

There is now a growing concern of a similar pending opioid crisis in the United Kingdom. A Times investigation revealed that an average of five people a day die in Britain from opioid use, “with opioid deaths up by 41% in a decade to about 2,000 a year.” According to the article, an increase in opioid prescriptions over the last ten years has created patient dependencies and a black market for the drug. Use of the synthetic opioid, Fentanyl, skyrocketed in 2017. Deaths caused by the drug rose by nearly 30% in 2017. Similarly to the US, an increase in prescriptions in the UK  between 2007 and 2017 spurred a rise in opioid use, addiction and overdoses. General Practitioners prescribed 23.8 million opioids in 2017, ten million more than a decade prior.  

Worryingly, nine out of the top ten highest opioid prescribing regions in the UK are in areas with lower socioeconomic status and greater poverty. These areas are largely located in North East and North West England. US states with the highest rates of poverty also rank among the top states with the worst opioid epidemics. West Virginia, New Mexico and Kentucky all rank among the top ten states with the worst rates of poverty and opioid addiction, according to two US News and World Reports studies.

People in these lower socioeconomic areas are more likely to work in jobs with intensive manual labour that can lead to increased injury later in life. Higher rates of poverty also indicate that people may not have access to high-quality healthcare. In these areas, doctors may be more willing to prescribe opioids to satisfy a patient’s pain, leading to higher rates of dependency and addiction.

Despite the similarities in the trajectories of the two crises, the UK may be in a better position to curb the impact of the epidemic and avoid the US’s mistakes. Culturally, the greatest difference between the US and the UK opioid epidemics is the use and acceptance of treatment.

Patients struggling with opioid addiction commonly take a withdrawal drug, such as methadone, to reduce the craving for opioids. The withdrawal drugs are forms of opioids in doses large enough to fend off withdrawal but small enough to prevent a high. An addiction patient in the UK has numerous ways to receive treatment including in a hospital, at a clinic, or through at-home treatment. Methadone treatment in the US is vastly underused because of strict, sometimes prohibitive, regulations that prevent individuals from accessing it. Federal legislation caps the number of patients a single doctor can treat with withdrawal medications, only around one-third of addiction treatment centres in the U.S. offer methadone treatment and many states require extra training for health officials to administer it. These measures are meant to prevent further addiction but can prohibit individuals, particularly in low-income areas, from receiving treatment because of time and cost related obstacles.  

In both the US and the UK, serious challenges lie ahead in fixing an opioid epidemic that disproportionately impacts low-income citizens. However, the UK may have a greater chance of reversing course because of its existing healthcare system and addiction treatment structures.

Karissa Wadick is a Research Assistant at Bright Blue.