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Why Do Americans Use More Painkillers Than Other Countries?

By Beth Leipholtz 03/26/18

A recent analysis examined why Americans consume six to eight times more opioids than Italians and the French.

While Americans take more prescription opioids than any other country’s population, research suggests it’s not because Americans are facing higher levels of pain.  

This information comes from Keith Humphreys via the Washington Post. Humphreys is a professor of psychiatry at Stanford University and an affiliated faculty member at Stanford Law School and the Stanford Neurosciences Institute.

In 2008, a team of researchers studied pain in 18 countries, using the same methods. In the United States, chronic pain prevalence was at 43%. The two countries closest to the United States in that aspect were Italy, at 42.8%, and France, at 47.8%. 

However, Humphreys states, that is where the similarities end. He writes that United Nations data for 2012 through 2014 demonstrates that the number of daily doses of opioids per capita are similar in Italy (6,246) and in France (8,706). However, that number jumps dramatically in the United States, at 50,142.

“In other words, despite suffering chronic pain at a similar rate as Italians and the French, Americans consume six to eight times as many opioid painkillers,” Humphreys writes. 

One argument, Humphreys says, is that France and Italy do not have good healthcare systems and do not provide patients with medication as needed. However, statistics prove otherwise. Specifically, Humphreys writes, life expectancy at age 65 is higher in Italy and France than it is in the U.S.

A second argument, according to Humphreys, is that the pain levels in the United States would be higher if opioid consumption was lower. But, Humphreys says, nothing supports the idea that pain in the U.S. is at higher rates than it was before opioid prescribing quadrupled in the late 1990s.

“The reason that Americans consume so many opioids is therefore not because they suffer more pain than people in other countries,” Humphreys writes. “A more likely explanation is that the United States regulates opioid manufacturers and distributors far less rigorously than do Italy, France and, indeed, virtually all other developed countries.” 

Finally, Humphreys states, the U.S. allows opioid manufacturers to market “aggressively” and to “donate generously to political causes and regulatory bodies.”

“It is those features of American exceptionalism, and not exceptional physical pain, that sparked the worst prescription opioid epidemic in history,” Humphreys affirms. 

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