Adequacy of opioid analgesic consumption at country, global, and regional levels in 2010, its relationship with development level, and changes compared with 2006

J Pain Symptom Manage. 2014 Feb;47(2):283-97. doi: 10.1016/j.jpainsymman.2013.03.015. Epub 2013 Jul 17.


Context: In most countries, patients do not have adequate access to opioid analgesics because of barriers resulting from the abuse potential of these medicines.

Objectives: To provide an analysis for the adequacy of the consumption of opioid analgesics for countries and World Health Organization regions in 2010 as compared with 2006.

Methods: We calculated the Adequacy of Consumption Measure using data for 2010 based on a method established by Seya et al. This method calculates the morbidity-corrected needs per capita for relevant strong opioid analgesics and the actual use for the top 20 Human Development Index countries. It determines the adequacy of the consumption for each country, World Health Organization region, and the world by comparing the actual consumption with the calculated need. Furthermore, the method allows us to calculate the number of people living in countries at various levels of adequacy. We compared our outcomes with data from Seya et al. for 2006.

Results: Most people have no access to opioids for pain relief in case of need; 66% of the world population has virtually no consumption, 10% very low, 3% low, 4% moderate, and only 7.5% adequate. For 8.9%, no data are available. Between 2006 and 2010, 67 countries increased the adequacy of opioid consumption per capita. These changes are independent of countries' level of development.

Conclusion: The consumption of opioid analgesics remains inadequate in most of the world and, as a result, patients with moderate and severe pain do not receive the treatment they need. Governments, health organizations, and nongovernmental organizations must collaborate to address this situation, targeting their efforts at educational, cultural, health policy and regulatory levels.

Keywords: Opioid analgesics; access; controlled medicines; health policy; morphine; pain treatment; palliative care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / supply & distribution*
  • Analgesics, Opioid / therapeutic use*
  • Health Services Accessibility / trends*
  • Humans
  • Internationality*
  • Pain Management / methods
  • Pain Management / trends
  • Palliative Care / methods
  • Palliative Care / trends*


  • Analgesics, Opioid