We should not be pro-opioid or anti-opioid; we should be pro-patient

Categories: Care, Featured, Opinion, and Policy.

The International Association for Hospice and Palliative Care (IAHPC), in pursuit of its vision of a world free from health-related suffering, organized a high-level virtual policy dialogue on April 29 titled Protecting public health and welfare through balanced opioid governance. The historic event featured presentations by the Chairs of two Lancet Commissions: Dr. Felicia Knaul (Palliative Care and Pain Relief, 2018) and Dr. Keith Humphreys (Stanford-Lancet Commission on the North American Opioid Crisis, 2022). Dr. Knaul also serves as a Director on the IAHPC Board.

Dr. Knaul discussed the latest data on serious health-related suffering related to no or low availability of essential palliative care medicines in more than 80% of the world and reported on the lopsided evidence base, which reveals a 90/10 split in research on opioid misuse and
harms, compared to the public health harms of lack of access. She called for a more balanced approach in both policy and research, saying “balancing doesn’t mean doing less on opioid use disorder, which is why the Commission Keith led is so important. It means doing more on access and pain disparities.”

Dr. Humphreys cited the legal and illegal tactics of the pharmaceutical industry, which his Commission warned is using the “big tobacco” playbook to peddle expensive opioids to the rest of the world, given that they are no longer allowed to market fraudulently in the US. He said
that the US now has the obligation to “be a good global citizen” and forbid US companies from operating fraudulently overseas in countries with weak regulatory systems.

In a dialogue with his Lancet counterpart, Dr. Humphreys said “the global community must develop policy options for Lower and Middle-Income countries other than the choice between ignoring serious pain, which Dr. Knaul’s Commission has shown, or doing a deal with the devil, like the North Americans did. These companies are profit seeking and do not care about public health.”

The recommendation of both Lancet Commissions was:

“To respond to pain and palliative care needs in low-income nations as well as to prevent such countries from being exploited by for profit opioid manufacturers, international agencies should coordinate distribution of free generic morphine to hospitals and hospices.”

The Chair of the Commission on Narcotic Drugs, His Excellency Ambassador Ghislain D’Hoop of Belgium, moderated the panel, which also included Ms Maria-Goretti Loglo, Esq a human rights lawyer from Ghana who helped develop the Model West African Drug Law, and Dr. MR Rajagopal, Chairman of Pallium India. Both presented on the need to improve access to, and availability of internationally controlled essential medicines from the perspective of civil society organisations working with affected populations.

Representatives of the World Health Organisation, the United Nations Office of Drugs and Crime, and The International Narcotics Control Board commented on the policy recommendations of the two Commissions and proposed a roadmap with next steps.

The event was co-sponsored by the Vienna NGO Committee on Drugs and the UN Office of Drugs and Crime, which is currently running a year-long social media campaign titled #NoPaNentLemBehind, an initiative of Ambassador D’Hoop. The event concept note is available on the Advocacy section on the IAHPC website.

Please contact: Katherine Pettus, kpettus@iahpc.com for more information on this press release.

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