Seven substances dominate the global availability of opioids under international control for medical consumption.
Expressed in S-DDDs (defined daily doses for statistical purposes), methadone, followed by hydrocodone, fentanyl, buprenorphine, oxycodone, codeine (including preparations) and morphine, accounted for some 90 per cent of global availability for medical use in 2024.
Despite this concentration, regional patterns differ markedly: fentanyl for medial use is most widespread in Western and Central Europe and North America, oxycodone and hydrocodone in North America (notably in the United States), buprenorphine in North America, Western and Central Europe and South Asia, and codeine (excluding preparations) in South America, North America and Asia.
Fentanyl and its analogues accounted for a fifth of all opioids consumed for medical use and constituted the second most widely used group of opioid substances worldwide, after methadone, in 2024.
The availability of nitazenes, which have been responsible for rising drug-related deaths in several countries in recent years, was extremely low (0.0000002 per cent of all opioids under international control in 2024). Legal use in 2024 was limited to etazene, protonitazene and butonitazene, mainly used for research rather than medical purposes.
