There remains a large discrepancy between the Global North and the Global South in the availability of internationally controlled pharmaceutical opioids for medical use - even though the gap is declining.

• Between 2015 and 2024, the per capita availability of pharmaceutical opioids for medical use in high income countries declined (-15 per cent) while in low- and middle-income countries availability increased strongly (+263 per cent); Nevertheless, availability in low- and middle-income countries remained low at less than 6 per cent of the per capita quantities available in high-income countries.
• In 2024, 87 per cent of the global population lived in countries where the availability of internationally controlled pharmaceutical opioids for medical use was below the global average.
• Availability of pharmaceutical opioids for medical consumption remains high in North America and extremely low in Africa and in Small Island Developing States of the Pacific and the Caribbean.