Overview of opioid overdose statistics globally

In 2019, overdose deaths led to the loss of 12.9 million years of healthy life worldwide, due to both disability and early mortality [^1]. That same year, opioids were implicated in 69% of all drug-related deaths globally, making overdose the third leading cause of death after tobacco and alcohol use. The severity of the overdose crisis demands a strong response, but many countries continue to face challenges with inadequate interventions and limited access to quality treatment options.

Between 2019 and 2021, the USA’s overdose mortality rate surged by 50%, increasing from 215 to 322 deaths per million residents. This sharp rise outpaced Scotland, where the rate saw a modest 3% increase over the same period. The most significant increase in the USA occurred in 2020, with continued growth in 2021. A comparable rise in overdose deaths was observed only in Canada, where opioid toxicity deaths rose from 99 to 209 per million — a 111% increase. In contrast, the mortality rate from all drug types showed slight increases in parts of the UK (England and Wales, Northern Ireland, and Scotland), Portugal, and the Netherlands, while Australia and Sweden experienced small declines. Yet, these changes were minor in comparison to the USA [^2].

In Europe, despite an estimated 0.33% of the population using opioids, high-risk opioid use remains stable [^3]. Similarly, Scotland’s opioid dependence rates are high but steady [^4]. In the USA, however, the opioid crisis continues unabated, with overdose deaths climbing steadily [^5]. Opioid-related deaths increased by over 16% between 2020 and 2021 alone, with synthetic opioids responsible for 88% of these fatalities and heroin for the remaining 11%.

Will Europe soon mirror the US opioid crisis?
The rising rates of opioid prescriptions, including oxycodone and fentanyl, have contributed significantly to the US crisis [^1]. Recent research shows early signs of a similar pattern in the UK, with buprenorphine and fentanyl prescriptions increasing at alarming rates. Opioid prescriptions in the UK have risen by 400% over the past decade. Although prescription opioid use is growing across Europe, the UK, especially Scotland, is currently the only country showing early indicators of a crisis similar to the USA’s.

In North America, the rise in synthetic opioid use has escalated into a public health crisis, particularly among populations with limited access to services. Illicitly manufactured fentanyl has overtaken heroin and prescription opioids as the primary driver of the opioid overdose epidemic. In contrast, the situation in the EU is different. Heroin has been the primary opioid of concern since the 'epidemic' of the 1990s and 2000s. Currently, available data indicates that the heroin-using population in the EU is aging, with little evidence of significant new initiations [^6].

In Africa, opioids are the leading cause of drug-related deaths in many countries, including South Africa, Kenya, and the Seychelles. They are also the primary substance for those seeking treatment for substance use issues. Notably, opioid use rates among the drug-using population are 100% in the United Republic of Tanzania, 70.6% in Mozambique, 39.4% in Nigeria, 80.6% in Mauritius, 11.5% in Eritrea, 18.8% in Ethiopia, 7.3% in Madagascar, 5.1% in Morocco, 6.5% in Senegal, 45% in the Seychelles, and 17.3% in South Africa [^7].

In 2016, Iran, Pakistan, Iraq, Qatar, and the United Arab Emirates saw significant increases in heroin use, attributed to expanded heroin trafficking from Afghanistan [^7]. Conversely, heroin use stabilized in countries like Saudi Arabia, Jordan, and Israel, where stimulants have become more prevalent. In East and Southeast Asia, heroin use declined in 2016 in nations including China, Indonesia, Thailand, the Republic of Korea, and Hong Kong [^7].

If you want to see how your country compares to other countries around the world, you can use the data on this page: https://ourworldindata.org/grapher/death-rate-from-opioid-use?time=latest