Report 2023
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INTERNATIONAL NARCOTICS CONTROL BOARD
Vienna International Centre, P.O. Box 500, 1400 Vienna, Austria
UNIS Tel.: (+43-1) 26060-4949 Web address: www.unis.unvienna.org
INCB Tel.: (+43-1) 26060-4163 Web address: www.incb.org
7
INCB DATA CONFIRM PERSISTENT INEQUITIES IN USE OF
OPIOIDBASED MEDICINES FOR PAIN TREATMENT
Data reported to INCB conrm the persistent disparities between regions in the consumption of the main
opioid analgesics for pain treatment (codeine, dextropropoxyphene, dihydrocodeine, fentanyl, hydroco-
done, hydromorphone, ketobemidone, morphine, oxycodone, pethidine, tilidine and trimeperidine).
Almost all such consumption is concentrated in Western Europe, North America, Australia and New Zealand.
Consumption levels in other regions are oen insucient to meet the medical needs of the population.
Regional imbalances not a result of shortages of raw materials
These regional imbalances are not due to a shortage of opiate raw materials. Supply is more than sucient
to satisfy the demand reported to INCB by Governments, but INCB nds that the estimated requirements
of a large number of countries may not accurately reflect the actual medical needs of their populations.
For comparison purposes, INCB uses an indicator, regional S-DDD
pm
, calculated on the basis of the total
population of the countries reporting consumption and the overall amounts of opioid analgesics reported
as consumed. In 2022, the reported consumption in some countries in North America, Oceania and Western
and Central Europe resulted in regional averages of 15,467 S-DDD
pm
for North America, 9,720 S-DDD
pm
for
Western and Central Europe and 5,327 S-DDD
pm
for Oceania. North America remains the region with the
highest consumption of opioids for pain management in the world. In comparison, average consumption
levels in East and South-East Asia, Central America and the Caribbean, Africa and South Asia were less
than 220 S-DDD
pm
.
Inadequate levels of consumption of opioid analgesics in East and South-East
Asia, Central America and the Caribbean, Africa and South Asia
INCB considers levels of consumption of opioid analgesics in quantities between 100 and 200 S-DDD
pm
to
be inadequate, and in quantities of less than 100 S-DDD
pm
to be very inadequate. In this context, the aver-
age levels of consumption reported in 2022 in East and South-East Asia (217 S-DDD
pm
), Central America and
the Caribbean (170 S-DDD
pm
), Africa (62 S-DDD
pm
) and South Asia (16 S-DDD
pm
) are of particular concern.
INCB stresses that there is an urgent need to increase the availability of and access to opioid analgesics and
to improve their prescription and use, especially in countries reporting inadequate and very inadequate
levels of consumption. INCB calls for targeted public policies supported by Governments, health systems
and health professionals, civil society, the pharmaceutical industry and the international community.