Millions die suffering amid global opioid gap, report says

No access to morphine leads to the agonizing deaths of 26 million people a year, report says | Miami Herald

No access to morphine leads to the agonizing deaths of 26 million people a year, report says | Miami Herald

Almost 26 million people around the world die each year with serious suffering in part because of a huge gap in pain relief: The U.S. may be awash in opioid painkillers, but they're rare or unavailable in dozens of poor countries, says a new report.

A new report from a commission of global health experts finds that in many developing nation the needs for pain management and palliative care remain unmet.

The challenge? Improving palliative care in poverty-ridden countries while avoiding moves that can lead the USA into yet another addiction crisis. "For India it is estimated that at least 10 million people are likely to require palliative care every year", said Dr Rajagopal, chairman of Pallium India, and director of the Trivandrum Institute of Palliative Sciences (WHO Collaborating Centre for Training and Policy on Access to Pain Relief). An additional 35.5 million people live with unmanaged chronic pain conditions. She co-chaired a Lancet-appointed worldwide commission that spent three years studying the disparity and what she calls "the moral obligation" to help. Mexico meets 36% of its need, China 16%, India 4% and Nigeria 0.2%.

The 2010 natural disaster in Haiti highlighted the scarcity, as doctors lacked opioids for people who were severely injured or needed surgery, the commission noted. The list also includes practical equipment like pressure sore-reducing mattresses, adult diapers - and a lock box for any needed morphine. Additionally, they've developed a framework model for palliative care services that could help health care systems in countries with fewer resources deliver services to patients dying from painful diseases or living with chronic pain. Providing pain relief for all those with medical need could cost as little as $145 million. "Efforts to prevent non-medical use of internationally controlled substances, such as morphine and other opioid analgesics, have overshadowed and crippled access to opioids for palliative care". In the US, prescriptions soared after marketing of newer opioids for less severe types of pain. Poor countries throughout the rest of the world have an entirely different story.

Still, "I wish they had included a stronger warning regarding the risks of a pain management agenda being co-opted by profit-seeking pharmaceutical companies as it was in the United States", said Stanford University psychiatry professor Keith Humpreys, who wasn't involved in the Lancet report.

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