What the United States can learn from Italian opioid control

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Courtesy of Dr. Mulas

The inside of Dr. Mulas pharmacy.

Simone Fenzi

The entrance to Dr. Mulas pharmacy in San Donato Milanese, Italy

SAN DONATO MILANESE, Italy — In the United States drug overdose is the leading cause of accidental fatalities. With over 2.8 million adults abusing it and around 20,000 overdoses per year, opioids make up the most widely used category of drugs in the United States.

While looking for the causes of this epidemic, researchers have found that pattern emerged as the gateway to addiction: prescription painkillers.

Emily Taylor is a Detroit resident and an advocate to fight inner-city high school problems. “Drugs have always been around in high schools,” Taylor says. “However, it is not until recently that I have started to see more opioids coming through.”

Taylor noticed this increase in popularity of opioids from speaking to some of Detroit students. She says, “while there has been a drastic increase in the dealing of them [opioids], it is hard to give painkillers the fault for the increase as, in this area, the recession hit hard and when you impoverish a whole city criminality spreads.”

All data taken from the University of Wisconsin-Madison

Graph showing the rise in use of Opioids in some of the major countries in the World

Taylor concluded that “while painkillers are virtually ubiquitous in the school system due to the easy access students can have to them from their family medical cabinets. I believe it is not the fault of the drug themselves but the lack of control.”

Italy is one of the countries that has figured out a way to control opioids whilst still making sure that the patients who need them can have access to them.

Dr. Ivano Mulas has been a pharmacist for 30 years and owns a pharmaceutical center in San Donato Milanese, Italy. “I believe that opioids are well controlled here in Italy,” Mulas says.

While he has seen an increase in prescriptions of opioids in the past 10 years he says “you can attribute that to a more standardized control over pain medications as well as a difference in the concept of pain between the patients.”

Mulas explains that in Italy these prescriptions are not given out lightly as some doctors still fear the problem of addiction. However, he also says that “there are currently no other options for the control of pain, so opioids has to be the answer.”

Italy has a standardized database where each prescribing doctor has a chance to see the history medicinal of the patient. This gives a chance to the doctors to have full knowledge over the medical history of a patient.

This database, alongside other tools, give Italy a better stance in fighting against addiction cause by pain relievers. “An increase in the number of users of opioid is a good thing [in Italy],” concludes Mulas, adding that since it is a controlled growth, “it means that we are giving needing patients what they need.”

The idea of a national database has been put forward many times in the United States, however there are still opponents lobbying against it. The unpopularity of actions taken to help addicts has roots founded in the definition of it.

Mario Borsani is an Italian resident who opposes rehabilitation for stricter sentences. “Addiction is a choice,” Borsani says. “As long as they [the addicts] keep being treated like victims we will not be able to solve the problem.”

Whatever might be the perception of drugs, countries like Italy show that through a stricter control it is possible to control the opioids crisis in the United States.

Courtesy of Dr. Mulas

The inside of Dr. Mulas pharmacy.

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