Untreated cancer pain a ‘scandal of global proportions’

Categories: Research.

A ground-breaking international survey published today shows that more than half of the world’s population live in countries where regulations aiming to stem drug misuse leave patients without access to opioid medicines for managing cancer pain.

The results from the Global Opioid Policy Initiative (GOPI) project show that more than 4 billion people live in countries where regulations leave cancer patients suffering excruciating pain. National governments must take urgent action to improve access to these medicines, says ESMO, with 22 partners that launched the first global survey to evaluate opioids availability and accessibility for cancer pain management. 

“The GOPI has uncovered a pandemic of over-regulation in much of the developing world that is making it catastrophically difficult to provide basic medication to relieve strong cancer pain,” said Nathan Cherny, ESMO Palliative Care Working Group chair and lead author of the report. “Most of the world’s population lacks the necessary access to opioids for cancer pain management and palliative care.” 

“When one considers that effective treatments are cheap and available, untreated cancer pain and its horrendous consequences for patients and their families is a scandal of global proportions,” he noted. 

The study, conducted in Africa, Asia, Latin America and the Middle East, assessed the availability of the seven opioid medications considered essential for cancer pain relief by the WHO Model List of Essential Medicines and the International Association for Hospice and Palliative Care: Codeine, oral oxycodone, transdermal fentanyl, immediate and slow release oral morphine, injectable morphine and oral methadone. 

While there are problems with the supply in many countries, the main problem is the over-regulation that makes it difficult for healthcare professionals to prescribe and administer these medications for legitimate medical use. 

“This is a tragedy born out of good intentions,” said Cherny. “When opioids are over-regulated, the precautionary measures to prevent abuse and diversion are excessive and impair the ability of healthcare systems to relieve real suffering.”

“The next step is for international and national organisations working alongside governments and regulators to thoughtfully address the problems,” added James Cleary, Pain and Policy Studies Group Director and Palliative Medicine Founding Director.

“Regulatory reform must be partnered with healthcare providers education in the safe and responsible use of opioid medication, education of the public to destigmatize opioid analgesics and improved infrastructure for supply and distribution,” he said.

Read the full press release, and download advocacy resources and infographics from the ESMO website

Find out about the implications for Africa on the Africa edition of ehospice

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