Ireland among six countries which have seen big rise in opioid-related deaths

Heroin is the most common illicit opioid, while prescription drugs have caused a widely publicised health crisis in the US

“Heroin is a semi-synthetic opiate synthesised from morphine, and is the most prevalent illicit opioid worldwide.”  Photograph: Getty Images
“Heroin is a semi-synthetic opiate synthesised from morphine, and is the most prevalent illicit opioid worldwide.” Photograph: Getty Images

Ireland has been named as one of six countries which have experience a significant rise in the level of opioid-related deaths.

A report, Addressing Problematic Opioid Use in OECD Countries, published on Thursday, says Ireland has experienced a "surge in overdose deaths" from the drugs alongside the US, Canada, Sweden, Norway and parts of the UK, where related fatalities have increased by more than 20 per cent between 2011 and 2016.

The report says it is a “mounting health and social crisis fuelled by the illicit drugs trade” as well as over-prescription by doctors.

Figures provided by the Organisation for Economic Co-operation and Development (OECD) show the rate in Ireland has increased from 41.1 per million in 2011 to 43.5 by 2016.

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Opioids come in two general categories: illicit types, with heroin being the most common, and prescription drugs, such as OxyContin, which have caused a widely publicised health crisis in the US.

Despite the high profile epidemic in the US the report notes that general awareness of the issue elsewhere is relatively low.

“Illicit opioids constitute a significant product of international illicit trade,” it says. “Heroin is a semi-synthetic opiate synthesised from morphine, and is the most prevalent illicit opioid worldwide.”

More recently the emergence of fentanyl and fentanyl analogues have become increasingly prominent in the illicit drugs trade in many countries.

Elsewhere, the over-subscription of opioid-based painkillers is considered one of the most important root causes of the crisis.

In the US there were 240 million prescriptions dispensed in 2015 – nearly one for every adult in the general population. Hydrocodone, oxycodone, codeine and tramadol are the main prescription opioids used for non-medical purposes.

Pain management

“The influence of pharmaceutical manufacturers on pain management has been considered significant by conducting marketing campaigns targeted mainly at physicians and patients, downplaying the problematic effect of opioids,” the report notes.

This has played out most prominently in the case of the billionaire Sackler family in the US, the owners of Purdue Pharma which manufactures OxyContin, a drug linked to thousands of deaths.

The growing backlash against big pharma’s role in the epidemic has seen the art world shun the Sackler family due to its involvement in pushing its painkillers – they had been a famous patron of museums.

In the US life expectancy levels dropped between 2015 and 2017 for the first time in more than 60 years, a development linked in part to opioid misuse.

The OECD report sheds light on other aspects of the phenomenon – pregnant women have been found to be experiencing problems – while it is also far more common in prisons.

"The prevalence rate of opioid use disorders in Europe was less than 1 per cent among the general public but 30 per cent in the prison population. Social and economic conditions have also contributed to the crisis with opioid use, and unemployment linked in some research."

Mark Hilliard

Mark Hilliard

Mark Hilliard is a reporter with The Irish Times