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Opiates, does Italy make more use or abuse?

September 26, 2018

In Italy more and more painkillers are used. In 2014, the Ministry of Health issued the alarm, stating that the risk of addiction for the elderly was more real than ever. Also significant is the data of the Italian Medicines Agency (Aifa), according to which in Italy the consumption of opiate drugs has steadily increased from 2014 onwards. We talked about this issue with Dr. Maria Fazio, head of the Humanitas pharmacy.


Lowering the pain threshold

The “pain threshold” is lowered and more and more painkillers are being consumed, especially opioids, which are, however, addictive. The main culprits of this new and worrying trend seem to be the older patients. According to Aifa, this is a “flag of alarm that shouldn’t be underestimated”.


Italy follows the American paradox

Italy is following the bad example set by the United States, where the abuse of opiate prescriptions has contributed to an increase in drug addiction and deaths from overdoses. In the State with stars and stripes we are facing a real public health emergency, also reported by the American President Donald Trump, who described the abuse of opioids in the United States as the new problem of the youth population, which before was hardly affected by this phenomenon. To prove it, a dramatic increase in deaths from overdoses. In 2016, more than 42,000 people died as a result of opioids, more than in road accidents. Every day, 42 people around the world die from overdoses of painkillers based on these substances.

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The “wrong” prescription of oxycodone

According to some experts, the problem is due to the “wrong” prescription of some analgesic drugs, in particular oxycodone, first synthesized in Germany in 1916, from thebaine, an opium alkaloid. In 1995 the Food and Drug Administration approved oxycontin, a high-dose, slow-release formulation of oxycodone. The substance, which until then had been prescribed almost exclusively to cancer patients for neoplastic pain, also thanks to very aggressive marketing that underlined its effectiveness and the scarcity of possible side effects in particular of the development of addiction, began to be prescribed by general practitioners for many other types of pain, from headache to bone pain to the treatment of post-surgical pain. Between 1997 and 2002, oxycodone prescriptions for non-cancer pain increased 10-fold. In the meantime, the drug has entered the illegal market: the crushed tablets of oxycodone make the substance immediately available, with an opioid effect as powerful as that of a dose of heroin. This use has begun to spread, especially among adolescents and young people, in a spiral that is difficult to stop.


The European situation

However, is there a crisis of synthetic opioids in Europe and Italy? “In Italy the phenomenon is certainly not as present as in the United States – said Roberta Pacifici, director of the National Center for Addiction and Doping of the Higher Institute of Health. The problem in our country, however, could also be underestimated, because some drug deaths are not accompanied by a timely analysis of the substance that caused the death. With synthetic opioids, among other things, being substances much more potent than morphine and heroin, it is possible to get to serious or fatal poisoning with much more ease. While in the United States the abuse has led to a crisis of drug addiction, in the rest of the world these same drugs are little present or little prescribed. According to a report commissioned by the scientific journal Lancet, 90 percent of all morphine in the world is consumed by 10 percent of the population in the richest countries. In other words, the United States consumes thirty times more opioids than necessary; India has 16% of its needs, Nigeria 0.2%.


The good news is that Italy, despite the increases in recent years, is still at the bottom of the list in Europe for the use of opioids in pain therapy.

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