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Access to Pain Treatment as a Human The combined suffering due to lack of opioid pain medicines worldwide is and the United States (US)—do.
Table of contents
- Access to Palliative Care as a Human Right by Human Rights Watch
- Cancer Pain Management in Developing Countries
- Declaration of Montréal
- The Opioid Crisis Is Also a Crisis of Speech
Access to Palliative Care as a Human Right by Human Rights Watch
Even if non-profit or third party organizations wanted to step in to fund and provide palliative care services, they must get permission from the government beforehand. Lack of legislation exists because of a range of issues. Palliative care may also be seen as a luxury or second hand issue when so much attention in the pharmaceutical industry is put on extending life and productivity and not enough is put on alleviating pain and discomfort.
When western legislators and philanthropists oppose opioid distribution in developing countries based on the opioid epidemic that is sweeping America, it leaves many in agony. Investment in getting opioids that are already on the market to places and people that desperately need them is another major hurdle. Many drugs to combat painful diseases like cancer and HIV have already been produced.
The issue is uneven distribution. Ironically enough, opioids are scarcest where they are most needed and most abundant where they are abused. The Lancet Commission on Palliative Care and Pain Relief was established in October in response to the general neglect of palliative care and pain relief in global health and universal health coverage discussions.
It will proceed to track progress on the recommendations made. Let that sink in for a minute. The relatively miniscule cost of introducing pain relief provides an opportunity to fill the gap quickly. The Commission determined an Essential Package which consists of the minimum palliative care that health systems should make universally accessible, even in resource-constrained and emergency settings.
The Essential Package provides information on appropriate and cost-effective medicines; and pricing, human resources and staffing models that can be universally applied. Investing in an Essential Package is one primary solution. However, there are other issues — including reducing stigma, creating regulation, educating populations about the use and misuse of opioids and exposing medical personnel to palliative care training — that should be addressed for palliative care to be broadly accessible.
The Lancet Commission details the steps that must be taken in order to incorporate palliative care and pain relief into universal health care in the future. Put even more starkly, opioids are virtually unavailable in over countries.
- Advocacy by International Pain Organizations!
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- Viewpoints.
According to the World Health Organization , this leaves over 5. They estimate that therefore each year a staggering 5. Opioids are on the WHO list of essential medicines for human health and well-being. Moreover, the drugs are inexpensive— just pennies per dose —and easy to administer. Crucially, most preparations are not under patent protection. So why do these disparities in access continue? Drug war propaganda promotes two myths about opioids: that they are always dangerous and instantly addictive. Pain is political.
To that end, the INCB has created an unnecessarily complicated and expensive narcotic supply chain system. Production and distribution is strictly licensed and supervised. Governments have to provide estimates and statistical returns to the INCB on the quantities of drugs required, manufactured, and consumed. On a national level, special drug control agencies are responsible for communicating with the INCB about the need for morphine, imports and exports, and for regulating and overseeing all domestic transactions involving controlled medications.
This onerous structure of surveillance and accountability makes it almost impossible for poor nations to comply. Their sights are set on stopping the latter and as a result access to pain medication suffers. They can comply with the demand for estimates, statistics, receipts, and the regulations around where drugs are stored, the need to have qualified people distributing, prescribing, and dispensing them. In many countries in Africa, where some of the most severe opioid shortages are found, few hospitals or pharmacies choose to stock morphine—the gold standard in treating moderate to severe pain—because of administrative obstacles and cost.
In Zambia , only hospitals can stock morphine, and in Nigeria—a nation of million people—oral morphine is available only from the National Drug Store.
Cancer Pain Management in Developing Countries
Cameroon has just one pharmacy that stocks oral morphine. Meanwhile in Mexico City , a metropolis of 21 million-plus people, just nine hospitals and pharmacies stock morphine due to cumbersome regulatory requirements. India is yet another example of a country where cancer patients must suffer unnecessarily; according to Dr. The lack of access to pain medication has horrific consequences all over the planet. Then they are often imprisoned and subjected to very harsh sentences for helping their family member. This opens the door for corporate leaders from all sectors and industries to act for the advancement of palliative care.
Declaration of Montréal
Despite the positive attention these programs have gained, they have only reached a small percentage of the population in need of pain relief. Over the past few years, the Ugandan government worked with private philanthropies such as Hospice Africa and Treat the Pain to bring some modicum of pain relief to people who are suffering. Uganda developed professional education in palliative care, allowing nurses to administer pain relief as well as doctors. Medical students are required to study pain management as a part of their course load.
In order to reduce confiscation and avoidable arrests, narcotics police were also taught about morphine, its affects and that it is a carefully administered medicine. These factors made it easier for patients to receive accurate information so they would be less likely to abuse palliative care drugs. Trained community volunteers work with medical professionals to identify and treat certain chronic illnesses.
The community volunteers employ outpatient clinics that are managed by doctor-nurse teams. The clinics also offer at home services. Because the NNPC is owned by the community, it is highly sustainable , while being financially-supported by the local and state governments.
These examples highlight the complexities of offering palliative care services and the strides that are yet to be made to ensure that care is expanded to entire populations. Yet, despite the inherent controversy of the topic, more palliative care research and recent efforts should give us hope that all people, regardless of income, may soon be afforded the relief they deserve.
Over 61 million people are affected by serious health-related suffering.
The Opioid Crisis Is Also a Crisis of Speech
What are the obstacles to providing palliative care? What are some solutions to expanding access to palliative care? What can the private sector do to expand palliative care?