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Researchers found that opioid dispensing levels were nearly 10 times higher in Mexico's wealthiest states than in the poorest.
If you're poor and terminally ill in southern Mexico, there's far less chance you'll get the painkillers you need for palliative care than your cousins in more prosperous regions, particularly those pharmacy-rich areas along Mexico–U.S. border, say UCLA researchers and colleagues who studied opioid dispensing levels across the country.
What's more, the researchers' paper in the journal The Lancet Public Health suggests it's likely that some of the opioids intended for Mexican citizens are ending up in American pockets.
Despite a Mexican government initiative launched in 2015 to improve access to prescription opioids among palliative care patients, the country has seen only a marginal increase in dispensing levels, and inequities in dispensing have left many of the nation's poorest residents without comfort in their final days, said lead author Dr. David Goodman-Meza, an assistant professor of medicine in the infectious diseases division at the David Geffen School of Medicine at UCLA.
"People in the poorest areas of Mexico are dying in pain," Goodman-Meza said. "A lot of work needs to be done to increase access to opioids for those who have a medical need for them in Mexico."
The researchers analyzed data on prescription drug dispensing from August 2015 to October 2019 for all 32 Mexican states and six large metropolitan areas. They compared opioid prescribing levels against the expected need for the drugs based on the burden of disease in each state.
While they found that opioid dispensing had increased overall by an average of 13% per quarter over that period, they also discovered that dispensing levels were nearly 10 times higher in states whose populations had the highest socioeconomic status than in those with the lowest. In addition, higher socioeconomic status was also associated with increased opioid dispensing within individual neighborhoods in the six metropolitan areas.
The states with the highest opioid prescribing rates were Baja California (234.5 prescriptions per 10,000 residents), Mexico City (65.8 per 10,000), Nuevo Leon (58.7 per 10,000), Sonora (56.5 per 10,000) and Jalisco (51.9 per 10,000). Those with the lowest rates were Tlaxacala (0 per 10,000), Guerrero (0.6 per 10,000), Durango (2.7 per 10,000), Mexico state (4.3 per 10,000), and Tabasco (4.4 per 10,000).
Baja California, Nuevo Leon and Sonora all border the U.S., while Mexico City is its own state and sits between Mexico state and Tlaxacala in central Mexico.
