Opioids use has dramatically increased in some OECD countries, both of prescribed and illicit opioids. This has led to a sharp upsurge in addiction and overdose deaths, with serious social and economic consequences.

In this scenario, the OECD is analysing the opioids epidemic and exploring several policy strategies that can help countries address the issue. 



The OECD Health Division, through the Economics of Public Health team, is working on a project aimed to develop a comparative analysis of international policies and strategies to address and prevent problematic opioid use, and their effectiveness in reducing/preventing opioid-related harms.

The OECD Secretariat will collect data/information (interviews, questionnaire) from countries, especially where topic is of particular relevance and interests. The specific objectives of the paper to be published are to:

  • Analyse the rates of problematic opioid use that OECD countries are facing and identify possible drivers of those rates; and
  • Identify best practices for addressing problematic opioid use in OECD and other countries.


Opioids are a type of narcotic pain medication that have become the cornerstone therapy for the treatment of moderate to severe pain in many developed countries. The misuse and abuse of opioids might lead to opioid tolerance (the need to take higher and higher dosages of drugs to achieve the same opioid effect), drug dependence (the need to keep taking drugs to avoid a withdrawal syndrome) and addiction (intense drug craving and compulsive use). Higher doses of opioids can lead to an opioid intoxication resulting in drowsiness, slowed respiration, low blood pressure, which in the end can produce an overdose death.

Opioid analgesic prescribing has increased dramatically in the past years in countries such as the United States and Canada, and many patients are being treated using opioids for chronic non-malignant pain. In parallel, the use of illicit opioids has also increased, both of diverted pharmaceutical opioids (e.g. oxycodone, hydrocodone, morphine) and of illicitly-produced opioids (e.g. heroin, fentanyl). This scenario has rapidly escalated the use of healthcare services, for instance, of emergency consultations and hospitalisations, and has mounted the number of overdose deaths to alarming numbers.This has created the so-called ‘opioid crisis’, which is strongly affecting Canada and the United States. In addition, other OECD countries such as Australia and some European countries, have also began to experience raising trends of opioids consumption and overdose deaths.


The prescription of opioids per capita is significantly higher in the United States than elsewhere in the OECD

Per million


Source: OECD (2018), OECD Economic Surveys: United States 2018, OECD Publishing.
Access the data behind the graph.

The Economic Survey of the United States, released in June 2018, highlights the substantial and profound economic cost of the opioid epidemic in the United States, where opioid prescription rates per capita are significantly higher than in other OECD countries. Prescription rates vary considerably within the United States, and there is a correlation between areas with higher opioid prescription rates and lower labour market participation. The report recommends new policies for limiting dependence, by adopting best practices in prescribing opioids, removing unused drugs from circulation, expanding the availability of medically-assisted treatments for addiction and ensuring employment and housing to minimise the risk of relapse.

Also read the blog post Opioid addiction costs many lives and harms livelihoods.





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