China Comes to Grips With Opioids

More than most countries, China has good reason to be wary of opioids, synthetic drugs like OxyContin that share opium’s power to suppress pain. In the 19th century the nation lost two wars to the British in a futile attempt to keep opium out of the country. After the defeats, part of what the Chinese call their century of humiliation, millions of people became addicted to the drug: In the early 1900s more than 25 percent of Chinese men used opium regularly. One of the government’s proudest achievements after the communists took power in 1949 was wiping out “the scourge of opium,” as China’s State Council put it. Partly out of that historic sensitivity, China today restricts the use of opioids far more tightly than the U.S. and other Western countries.

China’s aversion to opioids is part of a global puzzle: How do hospitals, health ministries, and pharma companies use these powerful painkillers effectively without laying the groundwork for serious abuse and addiction? Nobody has the answer. Instead the world’s use of opioids is seriously lopsided, as the UN-linked International Narcotics Control Board reported in February. Almost all of the world’s opioids are consumed in North America, Europe, Australia, and New Zealand. The U.S., facing an epidemic of prescription painkiller abuse, consumed 43,879 defined daily doses (a standard unit for measuring drug consumption) of opiates per million people in 2011-13, while China consumed just 91.