Lead Author: Sebastian Saville
Organization: International Doctors for Healthier Drug Policies
IDHDP is an international network of over 1250 medical doctors from 100 member states with the objective for health to underpin all future policies aiming to address the world’s drug problem. IDHDP is providing a brief contribution on the inequity of access to pain medication.
In 1998, the UN General Assembly Special Session (UNGASS) on drugs issued a declaration outlining its 10-year strategy to "eliminate or significantly reduce" the cultivation of marijuana, coca, and opium poppies. "A drug-free world -- we can do it!" was the motto adopted.
This strategy has had dreadful consequences for the poorest, most marginalized and already stigmatised members of society. Whether it is incarcerations in the USA, deaths in Mexico, preventable drug-related deaths or HIV and HCV transmission in former Soviet Union countries, it is the poor and disenfranchised who have suffered the consequences.
It is unthinkable that in 2016 – the international drug control system to prevent the misuse of drugs like heroin appears to have contributed strongly in preventing access to opioid analgesics, particularly morphine and creating an unnecessary atmosphere of fear when it comes to the prescribing/dispensing of these drugs for the treatment of pain.
International drug control systems to prevent the misuse of drugs like heroin are acting as a barrier to access to opioid analgesics for the treatment of pain (1). This in spite of the fact that member states are obliged to ensure controlled medicines are made available and any restriction of access constitutes a violation of the right to health.
This has contributed to a situation where at least 75% of the world’s population, has very little or no access to opioid analgesics, particularly morphine for the treatment of pain (2). This leaves the inevitable situation of huge numbers of people suffering intolerable pain whether dying of cancer, with end-stage AIDS and other terminal illnesses, accidents with acute pain, women in labour and having complications in childbirth, wounded victims of war torn areas or many other situations that bring about severe pain (3).
In what can only be described as a completely unacceptable contrast – the USA, Australia, Canada and the UK consumes 68% of the global supply of opioid drugs (4). These countries seem to have managed quite easily to develop systems to ensure proper access to opioid analgesics for all when it comes to the relief of severe pain.
IDHDP believes that it is time for a completely unambiguous statement from the UN that every member state should prioritize the removal of any obstructions preventing people in their country from receiving opioid analgesics when necessary.
As an organization representing doctors from over half the member states, IDHDP hopes that during UNGASS in April 2016 there will be opportunities to put in place strong directives to make deep and lasting inroads into this terrible injustice. This opportunity must not be lost.
Bibliography and References
1. (Report to the International Federation of Health and Human Rights Organisations (IFHHRO) 2012 http://www.ifhhro.org/images/stories/ifhhro/Books_reports_articles/ifhhro_poor_access_to_pain_treatment_2012.pdf)
2. (INCB Report 2014 https://www.unodc.org/lpo-brazil/en/frontpage/2015/03/04-junta-internacional-de-fiscalizacao-de-entorpecentes-lanca-o-relatorio-anual-de-2014.html)
3. (WHO Briefing Note 2012 http://www.who.int/medicines/areas/quality_safety/ACMP_BrNote_Genrl_EN_Apr2012.pdf)
4. (ESMO Report 2010 http://www.esmo.org/content/download/14123/252826/file/Global-Access-to-Pain-Relief-Evidence-for-Action.pdf)