America is in the grip of "an unprecedented epidemic of deaths" from opioid abuse, which New Zealand should learn from if it wants to avoid local fatalities, a medical article warns.
The article in Friday's New Zealand Medical Journal said fatal overdoses have been skyrocketing in the US as Americans now consume 80 percent of all opioids made in the world.
It had led to there being four times as many overdose deaths in 2015 as in 1999 with 63 percent of these (33,091 out of 52,404) involving opioids, it said.
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Originally thought to be caused by doctors handing out too many drugs, the rise in prescription abuse has also been accompanied by a rise in the use of illegal drugs, such as heroin and "phamaceutical look-alikes", like illicit fentanyl.
Article author Paul Morrow said the American experience may be a warning for New Zealand after local opioid-related deaths jumped 33 per cent from 2001 to 2012.
"Although we are not currently experiencing the same rate of opioid deaths as in the US, there are deaths due to opioid drugs," he said.
Some lessons from the US had already been addressed locally, with steps having been taken to more closely regulate how doctors prescribe opioids, he said.
Other lessons, such as how a flood of illicit fentanyl hit American streets, were not yet in play here.
But one step New Zealand should take now was to create a better reporting system when there was a suspected overdose death, he said.
This would involve collecting data from coroners, pathologists, emergency departments and St John ambulance.
It could then act as an "early warning system" alerting health authorities if there was a spate of overdose deaths or if a new dangerous synthetic drug had hit the streets, Mr Morrow said.
Wellington Hospital emergency medicine specialist Dr Paul Quigley welcomed the article, saying American doctors had "almost completely" created the US opioid crisis by over-prescribing the drug.
Then after some high profile celebrity deaths, the country greatly restricted access to the pain killers in a "knee-jerk" reaction that led addicted users to turn to street varieties and drugs like heroin.
"As long as in New Zealand we continue to recognise that doctors are the biggest opiate drug dealers we will avoid many of these problems," Dr Quigley said.