Current Addiction Reports

, Volume 6, Issue 1, pp 41–48 | Cite as

Hot Topic: Global Trends in the Use of Opioid Analgesics

  • Juliana ErthalEmail author
  • Stefano Berterame
  • Philip Clare
  • Richard P. Mattick
Opioids (D Fiellin and J Donroe, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Opioids


Purpose of Review

This study aimed to contribute to the debate on the availability of opioids for pain management by comparing regional and global trends for controlled strong opioids most commonly used for pain over the past 21 years. We conducted a series of analyses on the use of 12 opioids, with a focus on fentanyl, hydrocodone, hydromorphone, morphine, and oxycodone over the 21-year period of 1995–2015, at a regional and global level with country-level data, using random intercept mixed models to assess for change over time and interactions, and controlling for country economic development.

Recent Findings

Despite the sufficient supply of opioids to cover global demand, potent opioid pain medications are not available in many regions of the world. Prices of basic off-patent opioid formulations are significantly higher in poor countries as compared to lowest global prices, whilst countries may be under pressure to acquire expensive formulations. This results in lower availability of opioids for pain management in lower-income countries.


The analysis shows that, when adjusted for country-level gross domestic product (GDP) per capita and Human Development Index (HDI) category, the most significant trends in opioid consumption for pain management are those of morphine and fentanyl. Whilst the trend for use of morphine has remained relatively stable, fentanyl use has risen sharply in the past 21 years, even in regions where the levels of overall opioid availability are inadequate or very inadequate. The trends vary according to different regions of the world.


Opioid Analgesia Pain management Palliative care Morphine Fentanyl 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


The views expressed herein are those of the authors and do not necessarily reflect the views of the United Nations.

Supplementary material

40429_2019_234_MOESM1_ESM.docx (19 kb)
Supplementary Figure S1 Trends from 1995 to 2015 in use of five most common opioid analgesics—fentanyl, hydrocodone, oxycodone, morphine, and hydromorphone, adjusted for country-level GDP per capita and HDI category, and taking into account inefficiency in fentanyl patches (DOCX 18 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Juliana Erthal
    • 1
    • 2
    Email author
  • Stefano Berterame
    • 1
  • Philip Clare
    • 2
  • Richard P. Mattick
    • 2
    • 3
  1. 1.Secretariat of the International Narcotics Control Board, Vienna International CentreViennaAustria
  2. 2.National Drug and Alcohol Research Centre, Faculty of MedicineUniversity of New South WalesSydneyAustralia
  3. 3.International Narcotics Control Board, Vienna International CentreViennaAustria

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