Opioids and other controlled medicines are commonly used in palliative care. Some people associate opioids with a risk of dependence and misuse due to the epidemic of prescription opioid misuse and deaths caused by overdose, a particular issue in the USA. The ripple effect in low-and-middle-income countries (LMICs) has been patients suffering in pain and being denied access to treatment. This is largely due to restrictive laws, concerns about the side effects of the medicines, and a lack of knowledge and skills in using opioids and a lack of access to the medicines themselves.
Health professionals specialising in palliative care have called for laws to be relaxed and opioid stigma to be addressed due to the huge unmet need for pain relieving medicines. Less than 20% of the morphine produced for medical purposes worldwide is distributed to LMICs and this has barely changed in the last 20 years.
People experience unnecessary pain and suffering for months and years because they are denied pain relieving medication and some of them have attempted suicide in order to find an escape from the excruciating pain. Life can be made bearable for many people if only there were changes in the current laws that would favour them. Palliative care adds life to people’s days and there is no quality of life when you see a person gnashing their teeth and in so much pain.
An international treaty in 1961 was the genesis of the draconian laws which emphasised the control of opioids. In LMICs where the regulations have been relaxed, there is still a significant deficit of opioids for pain relief. This leads to people living in pain and psychological distress. Non-communicable diseases are on the rise in LMICs and there should be more emphasis on the well-being of people living with these conditions.
A recent article published in The Guardian titled Pain-relief shortage in poorer countries ‘due to stigma of US opioids crisis’ explores many of these issues. Professor Julia Downing, the Chief Executive of the International Children’s Palliative Care Network (ICPCN) was featured among other well-known palliative care experts and this is what she had to say, “The implications are quite broad … If they’re unable to work, the family will become poorer and poorer, and then they can’t pay for school fees, so the children can’t go to school. The impact of having people whose pain is not controlled goes far beyond just that individual themselves.”
This article is part of a series on Non Communicable Diseases and is important in highlighting these issues. To find out more please visit the link leading to the article in The Guardian here Pain-relief shortage in poorer countries ‘due to stigma of US opioids crisis’