Dear HIFA colleagues,
Opioid misuse and related disorders represent one of the most complex and dynamic challenges in global public health. Although the magnitude and characteristics of the problem vary across countries, there is growing concern about the increase in consumption, the
diversification of substances — including synthetic opioids such as fentanyl — and the associated health, social, and economic consequences. This forum aims to create a space for exchange among health professionals, policymakers, and key stakeholders to analyze the
current situation, share experiences, and move toward more effective, comprehensive, and evidence-based responses.
How can we define opioid use disorders?
The crisis relates to three types of opioids:
1. Natural (eg morphine, codeine)
2. Semisynthetic (eg oxycodone, heroin)
3. Synthetic (eg fentanyl)
Opioid misuse leads to considerable morbidity and mortality.
Chronic health effects include dependence and addiction (opioid use disorder) with tolerance and withdrawal; infectious diseases (e.g. HIV, hepatitis C) from injection use; mental health disorders (depression, anxiety); chronic constipation, hormonal dysfunction, unemployment, poverty, homelessness, family breakdown, crime, and impact on relatives, spouses, children. Opioids cause around 480,000 deaths per year worldwide, of which about 150,000 are due to overdose.
Opioids are the dominant cause of drug-related deaths.
Example: United States ~80,000 deaths per year from opioids
LMICs have increasing opioid use but less surveillance data and less access to treatment (e.g. methadone, naloxone).
The burden is highest in North America but is rising globally.
Question for discussion: What does opioid addiction mean to you? Please can you share any personal experience of opioid addiction in your family or soacial network? If you are a health professional, can you share an experience relating to one your patients?
My personal experience: Personally my experience of opioid addiction is limited. When I was at school, at the age of about 12, I was close friends with another pupil, Richard. We drifted apart over the next 2 years, then I heard he was dead from an overdose of heroin. Later, while at medical school, I worked at a pizza restaurant on Saturdays and it was an open secret that one of the staff, Peter, was addicted to heroin. I don't know if he is still alive or not.
If you are willing, please share your experience with an email to: hifa@hifaforums.org
With thanks and best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org