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Surging use of prescribed opioids among the Pakistani population.

Byline: Sabir Zaman and Shahid Irfan

Madam, social debate on the increasing issues related to prescribed opioids is rising worldwide, particularly in third-world countries, such as Pakistan. Opioids are drugs primarily used for pain management related to cancer, surgery and severe injuries.1 Unfortunately, as these prescribed opioids, which are a type of narcotic, are readily available, prescriptions often lead to abuse, addiction and dependency. A survey conducted in 2015 revealed that approximately 33,000 Americans died as a result of opioid overdose.2 Furthermore, a similar survey, which was conducted in Pakistan in 2013, revealed that about 4.25 million people suffered from substance dependency, among whom 1.6 million were using prescribed opioids for non-medical purposes.3 The United Nations Office on Drugs and Crime reported that Pakistan is one of the top 10 countries where people use both prescribed and non-prescribed opioids and opiates.4

In addition, more people die from prescribed opioids than cocaine and heroin.5 While a number of factors contribute to opioid addiction and deaths, doctors play a major role. It is important for medical practitioners to behave responsibly and understand how they can lessen the potentially negative consequences of prescribed opioids. In particular, physicians should only promote and prescribe opioids when necessary in the form of a safe dose (a low dose for a few days) for acute and chronic pain. Furthermore, it is also necessary for practitioners to discuss the risks of opioids with patients and suggest alternative therapies. In short, physicians and medical practitioners must take responsibility for improving their methods of prescribing opioids for effective pain management in order to minimize both the abuse of opioids and the related deaths.

Disclaimer: None to declare

Funding Source: None to declare

Conflict of Interest: None to declare.


1. Pergolizzi J, Boger RH, Budd K, Dahan A, Erdine S, Hans G, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract 2008; 8:287-313. doi: 10.1111/j.1533-2500.2008.00204.x.

2. Hedegaard H, Warner M, Minino AM. Drug Overdose Deaths in the United States, 1999-2015. NCHS Data Brief 2017; 273:1-8.

3. Hasan SS, Shaikh A, Ochani RK, Ashrafi MM, Ansari ZN, Abbas SH, et al. Perception and practices regarding cannabis consumption in Karachi, Pakistan: A cross-sectional study. J Ethn Subst Abuse 2019; 1-19. doi: 10.1080/15332640.2019.1667287. [Epub ahead of print]

4. Shabbir RK. Pakistan's opioid crisis. News release. The News Media Centre. [Online] 2018 [Cited 2019 January 20]. Available from URL:

5. Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers and other drugs among women--United States, 1999-2010. MMWR Morb Mortal Wkly Rep 2013; 62:537-42.

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Article Details
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Author:Sabir Zaman and Shahid Irfan
Publication:Journal of Pakistan Medical Association
Geographic Code:9PAKI
Date:Jul 9, 2020
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