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Int'l drug control regime denies access to pain relief
The present international drug control regime is stoking a global crisis of inequitable access to controlled medicines used as pain relief and in palliative care, an expert has warned
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he present international drug control regime is stoking a global crisis of inequitable access to controlled medicines used as pain relief and in palliative care, an expert has warned.
Michel Kazatchkine, UN secretary general special envoy on HIV/AIDS in Eastern Europe and Central Asia and a member of the Global Commission on Drug Policy, said that an estimated 5.5 billion people or 75 percent of the world's population had poor to non-existent access to opioid analgesics, in particular morphine, resulting in avoidable pain and suffering of people around the world.
Kazatchkine added that the UN drug control bodies and world governments continued to see opioid analgesics such as morphine as an 'evil substances'.
Governments and the people in general mostly lumped morphine together with other narcotics like heroin and cocaine, which was not the case, he said.
'It is understandable that many governments in the world have such an opinion, especially countries like Indonesia, which is now waging a war against illicit drug trading and use. But, the world should also see the legal use of controlled medicines to save people's lives,' Kazatchkine said in a telephone interview with The Jakarta Post last week.
Kazatchkine was attending the International Harm Reduction Conference in Kuala Lumpur where the Global Commission on Drug Policy released its new report entitled 'The Global Crisis of Avoidable Pain: The Negative Impact of Drug Control on Public Health'.
The Commission's members include former UN secretary general Kofi Annan, former Swiss president Ruth Dreiffus, founder of Virgin Group and social advocate Richard Branson and former presidents of Poland, Nigeria, Mexico, Portugal, Brazil and other distinguished individuals.
In 1961, the UN issued a treaty on the drug control system ' The UN Single Convention on Narcotic Drugs, or Single Convention for short. The Single Convention promotes access to controlled medicines and recognizes that adequate provision must be made to ensure the availability of narcotic drugs for medical purposes.
The preamble of the Single Convention implies an obligation not only to have supplies of controlled medicines available to states, but also for states to make those medicines available to their populations.
'But most governments emphasize a criminal justice approach to drug control, rather than a public healthcare, all to detriment of providing access to control medicine.'
The report said pain relief, through the use of controlled medicines, was an essential component of medical care for a number of groups such as terminal cancer patients, end-stage AIDS patients, women in labor, people suffering from injuries caused by accidents or violence.
Despite medical advances over the centuries, no alternatives to strong opioids, including morphine, for treating moderate to severe pain have yet been found.
The World Health Organization (WHO) estimates that tens of millions of people suffer from unrelieved pain annually due to a lack of access to pain relief medicines.
'Pain relief medicines are also required in surgery and post surgery situations', he said.
The Global Commission reports that 92 percent of the world's supply of morphine (for medication) is consumed by just 17 percent of the world's populations, with the consumption primarily concentrated in the global north.
By drawing attention to this highly important deficit in pain-relieving controlled medicines, within the report, the Global Commission demonstrated the possible outcomes of the upcoming UN General Assembly Special Session in 2016, which will present the opportunity to lay the foundation of a new drug control regime for the 21st century, including removing barriers to access to controlled medicines.
Meanwhile, Maria Phelan, deputy director of International Harm Reduction (IHR) added that most people would assume the deficit was due to insufficient supply or expense.
'The main reasons for lack of access are barriers linked to the international drug control regime. Drug policies at national and international level are imbalanced toward preventing diversion of these medicines rather than ensuring access for medical use,' Phelan said.
Such an approach has also created a negative environment and perception around controlled substances, so that access is unnecessarily complex and even doctors and patients become hesitant to prescribe or ask for these medicines.
Most governments emphasize a criminal-justice approach to drug control, rather than public healthcare, all to the detriment of providing access to pain-control medicine.
'Many doctors are working in a climate of fear and legal uncertainty. They are afraid of prescribing controlled medicines or of being charged with professional misconduct,' said Kazatchkine.
