Is Germany about to face a crisis of opioid deaths similar to the US?
A startling report in one of Germany’s leading national newspapers on Thursday suggested the country was on the brink of an opioid crisis. But a leading expert The Local spoke to was more circumspect.
“Germany risks suffering an opioid epidemic similar to that seen in the USA,” Christoph Stein, director of the anaesthesiology department at Charite hospital in Berlin told Die Welt.
In the US deaths related to the consumption of opioid painkillers has risen sharply in recent years. Addiction to legal painkillers now causes more deaths in the US than heroin, which is also opioid based.
Prescriptions of opioid-based painkillers by doctors in the US more than doubled between 1992 and 2012, a fact which has been held responsible for the steep rise in mortality. Studies suggest that people who become addicted to the painkillers sometimes turn to heroin, which is cheaper to buy on the street.
Stein warned that a similar crisis could soon await Germany.
“The use of opioids per person in Germany is already shockingly high and is barely distinguishable from the US,” he said. “Even for a relatively minor operation patients are sent home with big packs of opioids because the doctor wants to be sure that the patient is satisfied.”
What the Die Welt article neglects to mention though, is that actual death rates due to drug overdoses in Germany are far lower than in the US and also are not on the rise.
In 2016 a total of 1,333 people died in Germany due to drug overdoses, a far cry from the 63,600 recorded deaths in the US in the same year. Opioids were responsible for just under 800 of the German deaths, as opposed to an estimated 50,000 opioid related deaths in the US.
Meanwhile, the number of drug-related deaths has remained stable in Germany in recent years, despite a headline grabbing 15 percent rise between 2015 and 2016. When one compares the 2016 figure to the 1,394 people who died of drug overdoses in 2007, or the 1,449 who died in 2008, it becomes clear that there is little evidence of an upwards trend.
Peter Raiser, deputy CEO of the German Centre for Addiction, told The Local that he did not see it as likely that Germany was on the verge its own opioid crisis.
Raiser acknowledged that between 200,000 and 300,000 Germans are estimated to be dependant on opioids, but said that "there are two central factors that differentiate Germany from the US.”
“The first factor is that there are much higher requirements here for prescribing opioids. While they are a useful prescription against tumours for people who suffer from cancer, they should never be prescribed for chronic pains, like back pains.”
The second factor he named was a greater awareness among German doctors about when patients are becoming dependant on painkillers and what can be done to wean them off the drugs.