Last Updated on May 29, 2024 by Dr. Alberto Solà

The opioid crisis in the United States is real and is growing and tragically, there is no end in sight.  In 2017, opioids killed more than 70,000 Americans, according to the Centers for Disease Control and Prevention, and this number is so high that it actually caused a decrease in overall life expectancy in our country for the third year in a row, lowering the average to 78.6 years from a record high of 78.8 in 2014.   The figures are not yet available for 2018, but it is likely this trend has continued.

Although opioids are available around the world, the epidemic that we are currently facing and battling is unique to the United States.  Our country produces 30% of the entire world’s opioids, despite only having 5%of the world’s population. Why is this the case? How did we get here? Are Americans in more pain than the citizens of other countries?  Why are opioids, opioid use and abuse, and deaths from opioid overdoses more prevalent here than anywhere else in the world?

Do Americans Feel More Pain?

When seeing the high numbers of opioid users and deaths from opioids, the logical assumption is that Americans must be experiencing a great deal of pain.  In some or even many cases, this is absolutely true.  However, upon deeper reflection, this is clearly not likely or possible.  Americans are not built any differently than humans elsewhere in the world.  As a whole, we certainly do not have more difficult lives than the citizens of a vast number of other countries, and we are not particularly well known for participating in hard, physical labor that may lead to a lifetime of injury and recovery.  Although there are a lot of motor vehicle accidents and other severe injuries within our borders, they are surely not higher in number than similar incidents elsewhere. 

According to studies in this area, many Americans do experience chronic pain, and about 20% of the individuals in our population – around 50 million people – report consistent or reoccurring pain when surveyed.  However, that percent is much higher in other countries. A 2018 report published by BMC Public Health found that Europeans report rates that are similar to those of Americans, and in some countries – such as France, Italy, Norway, and Ukraine – the rates were even higher and, in some cases, were as high as 40 percent. 

We must consider, then, that it is not that Americans feel more pain than people in other countries, but that perhaps we are simply experiencing it differently.   A paper by the National Bureau of Economic Research, entitled “Unhappiness and Pain in Modern America,” found that Americans perceive and report pain differently than people from other countries.  In other words, pain that citizens of other countries may just consider a part of growing old or an unavoidable, uncomfortable aspect of their daily lives is something for which, alternately, many Americans will seek medical attention and treatment. 

Why Do Americans Believe They Experience More Pain?

            There are a wide range of reasons for this, and many theories.  One respected and accepted theory suggests that income inequality may have something to do with it.  According to a report published by the CDC, people who come from a background of poverty or limited education tend to report chronic pain on a more frequent basis than people of higher socioeconomic status or education levels.  This may be because the people who come from poorer backgrounds work in jobs that do cause more pain.  On the other hand, other studies have shown that people from lower income backgrounds have less access to health care and more difficulty navigating the health care system, which may result in more prevalence of chronic pain in the long run.   Further, the emotional stress of financial insecurity has also been shown to have a direct impact on one’s physical pain level, according to an article published in Psychological Science in 2017.  Most likely, the connection between poverty and pain is some combination of these three factors.

Many studies have been able to show a correlation between opioid abuse and poverty.  Some of the poorest states in our country, such as Kentucky and West Virginia – which also have the highest unemployment rates in the nation – also have the highest rates of opioid use and addiction.

Another possible reason that Americans believe they experience so much pain may be even less surprising and more directly correlated.  The United States has more obese adults than any other country; according to a an article published in 2017, 38% of adult Americans are obese, and that number may be as high as 50% by 2030.  People who are overweight often experience additional health problems as a result, and one of the most frequently reported health issues reported is chronic pain.

Why Do Americans Take Opioids So Frequently?

Above, we have looked at whether or not Americans are in more pain than the citizens of other countries, and we have considered why they believe that they are.  Therefore, it makes sense that opioids are used and abused heavily in the United States.  However, this does not explain why they are not used and abused as frequently in other countries.  The potential answers to this question are complicated. 

The first and most obvious reason for rampant opioid use and abuse in our country is the frequency of which doctors prescribe these medications.   In the current era, pharmaceutical companies have spent billions of dollars marketing these drugs to doctors, including going as far as to offer a wide variety of perks to the doctors who prescribe them regularly.  A recent study published in JAMA Network Open found that the occurrence of opioid addiction and subsequent deaths were highest in counties in which this marketing was the highest.  Although the general public and doctors are well aware of the high addiction potential of these drugs, they are still prescribed at an alarmingly high frequency, which little to no warning to or follow-up with patients.

A second but likely lesser reason is the fact that the United States is one of only two countries in the entire world – along with New Zealand – that allows direct advertising of drugs to consumers. Some opioids have been advertised heavily on television and in magazines, and many Americans who experience pain have indeed followed directives to ask their doctor about the benefits of using a certain opioid, and have had it prescribed to them with few questions asked.

Finally, though, it all comes down to culture.  As mentioned above, many citizens of European countries experience chronic pain at the same or even a greater rate than Americans.  However, their response to it is far different.  While many Americans immediately turn to pharmaceuticals to remedy their ailments, Europeans instead see drugs as a last resort.  Instead, Europeans try physical therapy, natural remedies, and alternative medicine before ingesting anything to mask their pain.  In many cases, they find satisfactory results to their pain without ever moving on to taking opioids.  This demonstrates our vast differences in medical care clearly.  While many Europeans seek cures or relief from their pain, many Americans, who are often looking for a quick fix rather than a long term, sustainable one, instead choose to mask theirs, setting themselves up for a lifetime of painkillers, and likely addiction down the road.

How do we fix this?  Many doctors, scientists, politicians, and addiction recovery specialists are working on finding a solution to the opioid crisis all the time.  Unfortunately, if it truly is medical and American culture that is causing this epidemic, then there will have to be large, wide-sweeping changes to the fabric of America and within the American people before we can actually make any progress.  For now, all we can do is try – and hope. At Clear Sky Recovery, we offer ibogaine treatment for individuals who are struggling with addiction.  Our innovative methods are rooted in the African continent, using medicine drawn from the tabernanthe iboga plant.  Ibogaine has proven successful time and time again in interrupting addiction, and helping individuals who have experienced it to start anew, on a fresh path moving forward, free of the burden of addiction.  Our intake specialists are standing by to give you more information about our methods, our facility in Cancun, Mexico, and our successes so far.  We look forward to hearing from you, and to helping you begin a new and healthier life.  Give us a call today.