Too much or too little opioid use? A comment on Bosetti et al

The evolution of opioid-related mortality and potential years of life lost in Spain from 2008 to 2017: differences between Spain and the United States

Objective: To investigate the evolution of opioid-related mortality and potential years of life lost in Spanish general population from 2008 to 2017. To evaluate the differences between Spain and the US.Methods: A descriptive study using retrospective annual data from 2008 to 2017 in Spanish and US general population. Information on the population and opioid-related deaths stratified by age and sex was obtained from Spanish National Statistics Institute and the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death Database, according to the ICD-10 codes. Years of life lost, crude and standardized mortality rates are reported and compared with the results in US.Results: Crude rate of opioid-related deaths per 10⁵ inhabitants has changed from 1.68 in 2008 to 2.25 in 2017 in Spain, with around 30,000 years of life lost per year. The most affected groups were middle-aged men and women over 65, and the main cause of death was accidental poisoning. The standardized rates per 10⁵ inhabitants across the years were between 1.19 and 1.62 in Spain and between 11.17 and 20.68 in the US population.Conclusions: An opioid overuse crisis does not seem a likely scenario in Spain. However, it is a social problem that requires special health surveillance, particularly in middle-aged men and women over 65.