The USA Drug Supply Chain and Healthcare System
is a complex organism

doctor prescriptions

Some pharma companies start to introduce new opioid medications, very effective pain relievers,
to guarantee a solution to chronic pain.
The investments in marketing are huge:
in 2001 Purdue Pharma reach an expenditure of


The first campaigns for the promotion of opioids are aggressive.
Furthermore, the given information underrated the risks
of those drugs, chemically similar to heroin.
In 2007 Purdue Pharma is condemned for misleading marketing of OxyContin with a fine of


The main pharma companies active in the 90s were Purdue Pharma and Cephalon. In 1998 Purdue Pharma intensively promoted OxyContin – an opioid drug released in 1996 – with the campaign ‘I got my life back' addressed to doctors. The presented data about the risks of addiction was based on the study of short-term treatments and was not representative of the prolonged cures needed for chronic pain.

doctor prescritpions

Doctors choose opioid medications to ensure relief from pain
and better life quality to their patients.
The prescriptions for this type of medicines end up growing sharply, nearly doubling in a 15 years span.

145 milions prescriptions 1996 260 milions prescriptions 2012 215 milions prescriptions 2016

Unlike other countries, opioids become frequently adopted to treat also chronic non–cancer-related pain.
Even accounting only about the 4,4% of the global population,
in 2015 America consumed

30.2% of world distributed legal opioids
patient affected by opioids

Since the 1990s, the steady growth of prescriptions for opioids has coincided with an increase in victims of legal opiate overdose. Only in 2010, legislative efforts have begun to slow down the number of prescriptions, with no effect on the trend of deaths. This is likely caused by the increased prevalence of strong synthetic opiates and the strengthening of their illegal market. In any case, the consumption in the United States remains the highest in the world with 47,580 doses of narcotic drugs consumed per day per million people, according to 2015 estimates.

patient affected by opioids

Thanks to the efficacy of opioids, patients can easily get total pain relief and go back to their daily life.
The strength of the most common of those medications is clear when compared to their morphine equivalent.

Hydromorphone Oxymorphone Oxycodone Morphine 0,3 Tramadol 5 1,5 7 Fentanyl 50

The effectiveness of the drugs, their relatively easy purchase and the need to progressively increase the dose
lead a lot of people to misuse and abuse opioids.
At this point, the patient is one step away from addiction.

of Americans heroin addicted started with taking legal opioids 75%
death rate by ethnicity and sex

Differently from what you may expect, most of the opioids addicted are white men with means to afford insurance. The percentage is extremely high for young and middle-aged, both for men and women. In fact, the number of women taking legal opioids sharply increased during the years. Among all the victims caused by this epidemic, there are few worth to be mentioned as they are worldwide known: Heath Ledger, Paul Grey, Michael Jackson and Prince all died from legal opioids overdose.

The Opioid System is a complex organism

patient affected by opioids
deaths vs opioids

The paradox of a system for public health that started an epidemic

This phenomenon regards USA but think for a second to:

something legal
accessible to people
that can be dangerous to the death

Is there anything
similar in your country?

Project by

  • Luisa Cadelli
  • Yixiao Cai
  • Eleonora Cappuccio
  • Francesca Grignani
  • Paolo Vernocchi
  • Zhixuan Xiao


  • Paolo Ciuccarelli
  • Stefano Mandato
  • Michele Mauri
  • Simone Vantini
  • Salvatore Zingale


  • Angeles Briones
  • Gabriele Colombo
  • Beatrice Gobbo
  • Michele Invernizzi
  • Ginevra Terenghi