OECD Observer
Treat the opioid epidemic as a public health crisis
Addressing Problematic Opioid Use in OECD Countries

The opioid crisis continues to devastate families and communities, especially in North America, but also increasingly in Sweden, Norway, Ireland, and England and Wales. This is in part due to doctors’ over-prescription: in the United States, for example, 240 million opioid prescriptions were dispensed in 2015, nearly one for every adult in the general population. Illegal opioids are also increasingly available.

With greater availability, overdose deaths are rising. In the United States, 399,230 people died from opioid overdose between 1999 and 2017, while in Canada, more than 10,000 people died between January 2016 and September 2018, and in Australia, more than 1,000 people die each year. There’s an economic cost to this human tragedy, too – in the United States, for example, the opioid crisis led to the loss of 12 billion work hours between 1999 and 2015, ultimately costing the country 702 billion in lost real output.

This report looks at the magnitude of the opioid crisis across OECD countries, describing its impact on health care systems, social services, and law enforcement as well as the crisis’ impact on specific groups. Three out of four opioid deaths involve men, while prisoners are far more likely than the general population to abuse opioids. Pregnant women and mentally ill people are also more likely to be at risk.

What needs to be done? The report recommends that opioid use disorders (OUDs) be considered a chronic health condition and primarily addressed as a public health issue. This should guide the design of health policy responses, but also social policy and law enforcement strategies. For example, medication-assisted therapy, complemented with psychosocial support, could be supported both by the health sector and law enforcement, facilitating the connection of low-level offenders with health care. Likewise, health care networks can offer more recovery and reinsertion opportunities to OUD patients by having good communication with employment or housing support services. More closely monitored prescription by doctors and use of alternative chronic pain management options are also key to addressing the crisis.


OECD (2019), Addressing Problematic Opioid Use in OECD Countries, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/a18286f0-en.

©OECD Observer August 2019