Pain is universal, yet the prevalence of overdose and treatment of pain varies significantly between the united States (uS) and Western europe. overdose deaths are seven times more common in the uS compared to Western europe. cultural perceptions of pain, perception and treatment of opioid use disorder, pharmaceutical advertising, and rates and regulation of prescribing of opioids represent examples of factors that may be related to such differences between the uS and Western europe. As rhode Island continues to battle the devastating and well-documented national opioid overdose epidemic, we should consider how cultural, regulatory differences, and economic factors may influence pain and its treatment. [ABSTRACT FROM AUTHOR]