As has been the case for many years, the 2011 INCB data illustrate the continuing disparities in morphine consumption between high and low- and middle-income countries:

• high-income countries (as defined by the World Bank income-level classification) accounted for nearly 92% of medical morphine consumed in the world, but comprised only 17% of the total population. In contrast, low- and middle-income countries, representing the remaining 83% of the world’s population, consumed a mere 8% of the total morphine consumption.
• In 2011, there was a large and striking difference between the lowest amount of morphine consumed in a country (Nigeria: 0.0032 mg/person) and the highest amount (Canada 87.48 mg/person*) *Austria reported 222.79 mg/person of morphine in 2011, but uses morphine for opioid substitution treatment, so the second highest, Canada, is listed 
• 56% of the countries reporting to INCB in 2011 consumed less than one milligram of morphine per person

These figures point to the large and continuing disparity in morphine consumption among countries, and provide further evidence of the inadequate global treatment of pain, especially in low- and middle-income countries.

However, there continue to be some notable increases in opioid consumption in a few countries where International Pain Policy Fellows have been making progress to improve the availability of opioids, such as morphine:

• In Jamaica, the amount of morphine (mg/capita) consumed in 2011 represents nearly a seven-fold increase since 2001.
• Similarly, in Colombia, morphine consumption (mg/capita) has been stable since 2005, with a slightly increasing trend over the 7-year span.

As always, we are grateful to the International Narcotics Control Board (INCB) for their continued collaboration and for providing annual updates of these important data.