Has Germany Avoided the Opioid Epidemic?
When addressing a public health problem in one country, It can help to look at what other countries did or did not do to create better health outcomes. Could those strategies/programs be used to improve conditions in one’s own country? It’s certainly possible, and it’s at least worth examination.
Here’s one example. As the opioid addiction epidemic has ravaged much of the western world and the United States, Germany appears to have escaped the brunt of the crisis. What did Germany do differently? How did Germany avoid much of the opioid addiction crisis that is now a public health emergency and one of the leading causes of preventable death in the United States?
The Situation In Germany
In 2016 almost ten times as many Americans per capita died from drug overdoses than Germans. During that year, 21 Germans for every one million German residents died from opioid overdoses, compared to 198 Americans for every one million American residents dying from opiate overdoses.
Per Capita, three times as many Americans struggle with opiate addiction as Germans. In the United States, it is estimated that about 2.1 million Americans are hooked on opioids, as compared to about 166,000 opioid-addicted persons in Germany.
The past two decades have seen a considerable increase in addiction statistics in the U.S., while addiction rates in Germany have not changed much. Opioid prescribing has increased slightly in Germany, but nowhere near the rate of increase in the States, and there has been no opioid epidemic in Germany.
Why is this? For the most part, it comes down to a different approach to physical pain. In Germany, medical practitioners have never utilized opioid pain medication as a first-line approach to treating pain symptoms among patients. Prescription painkillers have only been used as a last resort after all other treatments for pain have been tried.
"Among the most important reasons we do not face a similar opioid crisis seems to be a more responsible and restrained practice of prescription."
Quoting Dr. Peter Raiser, the deputy managing director at the German Center for Addiction Issues, “Among the most important reasons we do not face a similar opioid crisis seems to be a more responsible and restrained practice of prescription.”
In Germany, doctors must always try alternative pain relief treatments first. And even if those don’t work, doctors still must screen patients extensively to make sure their patients are not at risk for addiction.
To shed some more light on the difference in how the United States and Germany address addiction-related issues, the Organization for Economic Cooperation and Development put together a detailed report that compared several nations in how they currently address various addiction crises. For example, that report indicates that Germany has moved towards decriminalization of drug use, whereas the U.S. has not.
Germany is also basing its opioid prescribing guidelines on peer-reviewed scientific recommendations, not the suggestions and urgings of pharma companies (who stand to profit significantly from more prescribing). Quoting the study authors, “The guidelines released in Germany by the German Pain Society address long-term opioid therapy for chronic non-cancer pain. Germany's guidelines represent a good example of evidence-based recommendations and included the participation of 26 scientific societies and two patient self-help organisations in their development.”
What Can We Learn from This?
It’s really quite clear. The German medical community has not been quick to use opioid pharmaceuticals as a “solution” to their patients’ pain symptoms. In fact, German doctors have been very hesitant to prescribe opiates, only utilizing such medications as an absolute last resort and even then monitoring patients’ results very closely.
This highly muzzled and conservative approach to prescribing is in stark contrast to the more or less unfettered approach to prescribing opiates in the States.
It’s worth mentioning that many doctors in the U.S. have begun to cut back on their opiate prescribing. However, this trend of curbing prescribing must continue and even ramp-up significantly if the U.S. is to hope to experience a significant reduction in opioid addiction.
If Someone You Care About is Already Addicted to Opioids
It’s certainly beneficial to examine how other countries deal with their public health crises. From a prevention approach, this exercise is quite helpful. However, if someone you care about is already addicted to opioids, preventive efforts are no longer relevant. If you know someone who uses opiate drugs and who cannot stop using them, the solution becomes one of rehabilitation and treatment.
Narconon offers a unique and successful program that has helped saved the lives of thousands of opiate addicts. For over 50 years, Narconon has utilized a workable drug rehab program that’s unlike any other in the world. If you know someone who is hooked on opiates, even if they started using opiates for legitimate pain reasons, contact Narconon today. Don’t let them go another day with a drug problem that could be fatal.
Sources:
- https://www.emcdda.europa.eu/countries/drug-reports/2019/germany/drug-induced-deaths_en
- https://www.cdc.gov/drugoverdose/data/statedeaths.html
- https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.pdf
- https://www.aerzteblatt.de/int/archive/article/205769/Estimation-of-the-number-of-people-with-opioid-addiction-in-Germany
- https://pubmed.ncbi.nlm.nih.gov/31461466/
- https://khn.org/news/how-germany-averted-an-opioid-crisis/
- https://www.oecd-ilibrary.org/sites/a18286f0-en/1/2/4/index.html?itemId=/content/publication/a18286f0-en
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