Life Asked Death – Access to Opioids

Life Asked Death – Access to Opioids


This patient in Myanmar has cancer which has affected her lungs. She’s in severe distress with pain, and gasping for breath. Morphine will help her breathe more easily and take away her pain, but none is to be had in the ward. Mr, Sein Hla Aung has a cancer which has eaten through from
his mouth into his chin. He has severe pain, which makes him want to
cry out in the night, but he suppresses his scream because of all the other patients in the ward. Morphine will control his pain, but only the weak opioid
Tramadol is available. Even if he is given one
of the precious vials of morphine from the ward, it will only relieve his
pain for a few hours. When he leaves the
hospital, he will have none. (tranquil world music) The Single Convention
of Narcotic Drugs, 1961, and its amendment in 1972 establishes a framework to
prevent abuse and diversion, but at the same time, ensures
the availability of drugs for medical purposes. Its preamble states that “the medical use of narcotic drugs continue to be indispensable
for the relief of pain and suffering, and adequate provision must be made to ensure the availability of narcotic drugs for such purposes.” The International Narcotics Control Board, the INCB, expressed its concern in 2007, that “the low levels of
consumption of opioid analgesics for the treatment of
pain in many countries, particularly in developing countries, continue to be a matter of
serious concern to the board. The board again urges
all Governments concerned to take steps to improve the availability of those narcotic drugs
for medical purposes.” The World Health Organisation, in two publications in 2000 and 2011, called for balance in national
opioids control policy, so that countries should
make opioids available for medical use, while controlling drug diversion and abuse. Some common obstacles
to opioid availability include fear of addiction,
lack of training of health personnel,
excessively strict laws and regulations, and
insufficient amounts of opioids in the hospitals where
doctors can prescribe them. Many countries have overly-strict
laws and regulations beyond what is required by
the international authorities. These include allowing
only certain doctors to prescribe opioids,
extra licencing exams for doctors, special prescription pads with limited numbers of days and amounts allowed for each prescription,
and keeping the medicines at certain government hospitals only. A simple checklist is available from the World Health
Organisation, to help clear these obstacles, so
that patients can obtain these medications, even when
they’re discharged home. We cannot ethically
walk away from suffering when it is within our power to relieve it. Things you can do today are first, send a clear
message to all doctors that they will not be penalised
for prescribing opioids according to the regulations. Second, send instructions to all hospitals on how to estimate quotas, how to order, store, and dispense opioids, and make sure that your country quota is adequate, and updated. Third, go through the
World Health Organisation checklist and see if you
have fulfilled the criteria to achieve balance in
opioids control policy. See whether your country needs to change any overly-restrictive policies. No government should allow
its citizens to die in pain because of the lack of opioid painkillers. Will you take action today?

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