Opioid use in Latin America: a vital challenge for health systems.

This viewpoint challenges the notion that Latin America is on the verge of an opioid use disorder crisis similar to that occurring in the USA and Canada. We critically analyse the evidence presented by León and colleagues, who argues that opioid prescribing patterns in countries such as Chile reflect an alarming expansion of misuse, especially in the context of chronic non-cancer pain. While acknowledging the growing availability of opioids in Latin America, we contend that this trend primarily reflects efforts to expand palliative care and rational opioid access for serious health-related suffering. Drawing from regional and national data, we show that increases in opioid consumption in countries like Chile are consistent with public health improvements, including national pain relief programmes and coverage of cancer patients with palliative care services. The evidence of opioid use disorder and non-medical use is limited and does not justify alarmist conclusions. We advocate for balanced strategies that address opioid misuse risks while ensuring access to pain relief, provided they are guided by international standards, data-informed policymaking, and transparent reporting of conflicts of interest. The global health community must prioritise equitable opioid access across Latin America to alleviate serious health-related suffering and uphold the principles of universal health coverage.