The blog pieces by Dr Willem Scholten, Consultant – Medicines and Controlled Substances, and Dr Katherine Pettus, International Association of Hospice and Palliative Care (IAHPC) Advocacy Officer, each address a different aspect of this topic.
Opioid overdose death epidemic sensationalised at the cost of pain patients
In his article: ‘Opioid overdose death epidemic sensationalised at the cost of pain patients’, Dr Scholten questions the current media discourse, especially in US media, around a “sudden epidemic of prescription opioid use.” He argues that unbalanced and uncritical reporting has led to a “sensationalisation” of opioid use that ultimately disadvantages people who need these medications for pain relief.
He refers to his recent article: ‘Negative outcomes of unbalanced opioid policy supported by clinicians, politicians and the media’, written in collaboration with Jack E. Henningfield, in which the authors analysed the origin of prescription opioids used by those who died from an overdose in the US. They found that most were obtained from an unofficial source. That is: opioids were never prescribed to the majority of those who overdosed.
This distinction between ‘prescribed’ and ‘prescription’ opioids, he argues, is critical. Policy-makers should not make it more difficult for people to be prescribed these medications.
Rather, Dr Scholten and his colleagues advocate that: “new policies should be based to the greatest extent possible on accurate evaluation of the science and epidemiology (of substance abuse and overdose), including a root-cause analysis.”
Dr Scholten closes by noting the importance of the global burden of pain relative to the burden from non-medical substance use. He urges policy-makers to acknowledge this fact while addressing the issue.
International Narcotics Control Board (INCB) supplement on controlled medicines: a great tool for advocacy
Dr Pettus writes about the new International Narcotics Control Board (INCB) supplement on controlled medicines, calling it: “a great tool for advocacy.”
The new supplement, published in Vienna on 3 February, describes the global state of availability of controlled medicines for the treatment of pain, mental illness and dependence syndrome.
It details the consumption levels of controlled medications as listed in UN drug control treaties, and provides recommendations for ensuring availability while preventing diversion and misuse.
Currently, although consumption of controlled medicines has increased in the world’s wealthier countries, global consumption remains far below the levels needed for basic treatment.
Barriers to sufficient consumption include fear of addiction, and lack of professional education and awareness around these substances and their use.
Dr Pettus calls for: “more robust support and collaboration (for organisations working to address these issues) from governments and UN organisations in order for the next INCB supplement to report that the training and awareness raising is taking place and that the pandemic of untreated pain is abating.”
She closes by noting that: “The new INCB supplement is a great tool for advocacy, and can be used by countries, regions, and globally to analyse the situation and argue for policies to promote greater education.”