Israel tops OECD in growth of opioid availability

Between 2011-2013 and 2014-2016, obtainability of legal opioids in Israel grew by 125 percent, according the report, titled “Addressing Problematic Opioid Use in OECD Countries.”

By TARA KAVALER/THE MEDIA LINE
Pills medicine medication treatment 300 (R) (photo credit: Srdjan Zivulovic / Reuters)
Pills medicine medication treatment 300 (R)
(photo credit: Srdjan Zivulovic / Reuters)
Israel has seen the largest increase in the availability of pain-killing opioids among Organization for Economic Cooperation and Development (OECD) member countries, according to a recent report.
Between 2011-2013 and 2014-2016, obtainability of legal opioids in Israel grew by 125 percent, according the report, titled “Addressing Problematic Opioid Use in OECD Countries.”
Anna Oliker of AZ House, a free, Jerusalem-based treatment center geared to the English-speaking Orthodox-Jewish population, told The Media Line: “Opioids are very dangerous. They’re accessible and not expensive. People get prescriptions and then they resell them.”
The United Kingdom and Slovakia saw the second and third highest growth in accessibility, at nearly 68% and 65%, respectively. The average rate of growth for OECD countries in the same period was 5.4%. The opioids’ most common use is for therapeutic purposes.
The report measures “availability” based on government-estimated figures that include medications not consumed by humans, such as opioids produced by pharmaceutical companies that are found unfit for use. Therefore, these figures do not completely correlate to opioid use.
Eric Levitz, who founded AZ House three years ago shortly after immigrating to Israel from Cleveland, Ohio, said the most common opioids in Israel were Fentanyl, Oxycontin and Percocet.
Oliker said she had seen a rise in the number of religious boys misusing opioids, especially smoking Fentanyl patches.
“It’s just been our experience knowing four or five boys in the last two years that this is a problem [in the community]. The Fentanyl patch is 1,000 times more potent than heroin and it’s not supposed to be smoked; it’s supposed to be worn.”
Levitz said that one of the reasons for the growth in availability was a low knowledge base among both professionals and the general population.
“I do not believe drug awareness in this country is very high in general, as well as in the medical community,” he said.
Levitz added: “The growth is not surprising because of the lack of education and how this country deals with this epidemic. There seems to be no signs of this slowing down. The evidence is in the archaic structures in place to deal with drug abuse.”
He attributed this to the type and cost of treatment available in Israel, as most major treatment centers accept only patients who are on welfare. 
“Their answer to drug addiction is to put the addict on welfare, give them disability [benefits] and send them to the same type of in-patient treatment center with low success rates. This shows their lack of understanding of addiction as a disease rather than a choice,” he said.
“We need to look at alternative solutions like the one we provide here at AZ House that slowly integrates them back into society instead of just keeping them locked up for a year and then releasing them and expecting them to know how to handle real life,” Levitz said.
Israel’s Health Ministry, in a statement issued to The Media Line, said: “Along with the clinical benefits, the use of opioids often involves addiction and other undesirable effects…. These phenomena require an examination of the policy in a variety of areas. Therefore, the director general of the Ministry of Health appointed a task force on addiction to opioids in February 2019. The task force is expected to submit its recommendations in the coming months.”
Gil Horev, media director of the Israel Authority for the Prevention of Violence, Alcohol and Drug Abuse, told The Media Line: “We are working with communities in local municipalities…. It’s a new problem.”
The OECD report indicates that the growth in the drugs’ availability does not translate into an equivalent increase in damage to people’s health.
“Other countries, including Israel… have experienced a growth in the availability of [pain killing] opioids in recent years but have so far not shown major signs of opioid-related harms,” the report reads.
In 2014-2015, there were 0.3 opioid-related deaths per 100,000 persons in Israel.
Oliker contends that opioid deaths are underreported in Israel because the police are not always trained to identify signs of opioid overdose. She believes that more lives could be saved if Narcan (Naloxone), a medicine that can be used in urgent situations when someone has overdosed, were more readily available.
“They’re training thousands of people in America to use it because it saves lives,” Oliker said.
Levitz notes that not all emergency responders in Israel have ambulances that carry Narcan.
“To decrease the use of these drugs, we can start by increasing the education in the medical field. We also have to work to remove the stigma of what a drug addict is,” Levitz said. “They are not just homeless bums under a bridge. They can be your mother, father, sister or brother.”
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