Everything on the Topic of Suffering

2007 September 10

Millions die in awful pain for lack of inexpensive opioids

Filed under: Opioids — robertdaoust @ 5:15 pm

Excerpt from  New-York Times article Drugs Banned, Many of World’s Poor Suffer in Pain:

“The World Health Organization estimates that 4.8 million people a year with moderate to severe cancer pain receive no appropriate treatment. Nor do another 1.4 million with late-stage AIDS. For other causes of lingering pain — burns, car accidents, gunshots, diabetic nerve damage, sickle-cell disease and so on — it issues no estimates but believes that millions go untreated. Figures gathered by the International Narcotics Control Board, a United Nations agency, make it clear: citizens of rich nations suffer less. Six countries — the United States, Canada, France, Germany, Britain and Australia — consume 79 percent of the world’s morphine, according to a 2005 estimate. The poor and middle-income countries where 80 percent of the world’s people live consumed only about 6 percent.” 

Abstract from Joranson DE, Ryan KM. Ensuring opioid availability: Methods and resources. J Pain Symptom Manage. 2007; 33(5):527-532:

“The pain and palliative care fields are encouraged to learn about government drug control policy and to engage with their governments to examine these policies and their implementation in order to address impediments to patient access to pain management. Although pain management is a necessary part of palliative care, it is often impossible because strict national and state regulations block access to opioid analgesics. It is important for us to know that in adhering to international drug treaties, governments often concentrate on drug control to the exclusion of their obligation to ensure opioid availability for medical and scientific purposes. Indeed, international health and regulatory authorities are increasingly concerned about wide disparities in national consumption of opioid analgesics and have called on governments to address barriers in their national laws and regulations that govern the prescribing of opioid analgesics. The Pain & Policy Studies Group (PPSG) has developed methods and resources to assist governments and pain and palliative care groups to examine national policies and make regulatory changes. Romania, India, and Italy are examples. The PPSG is developing several new resources, including a training program for Fellows from low- and middle-income countries, enhanced support of collaborators working on opioid availability, an internet course in international pain policy, an improved website with policy resources and country profiles, and new approaches to the study of opioid consumption indicators.”

2007 July 24

Pain Management: A Fundamental Human Right

Filed under: Opioids,Uncategorized — robertdaoust @ 11:16 am

An excellent article at http://www.anesthesia-analgesia.org/cgi/content/full/105/1/205. Title is Pain Management: A Fundamental Human Right. Excerpts:

“First, pain, whether acute or chronic, is inadequately addressed for a variety of cultural, attitudinal, educational, political, religious, and logistical reasons. Second, inadequately treated pain has major physiological, psychological, economic, and social ramifications for patients, their families, and society. Third, it is within the capacity of all developed and many developing countries to significantly improve the treatment of pain.”

“Strategies currently applied for improvement include framing pain management as an ethical issue; promoting pain management as a legal right, providing constitutional guarantees and statutory regulations that span negligence law, criminal law, and elder abuse; defining pain management as a fundamental human right, categorizing failure to provide pain management as professional misconduct, and issuing guidelines and standards of practice by professional bodies.”

“Given the tremendous amount of activity over recent years by preeminent international and national pain bodies and the raising of awareness about pain, it is now time for the UN to consider the declaration of an International Year of Pain Management. Doing so would have several advantages. It would harness the momentum of the current activity and advance the efforts made by national and international bodies. It would serve to place pressure on nations without pain policies to address this issue, and to oppose restrictive opioid regulations. It would encourage medical and nursing schools to integrate pain management within their curricula, and possibly, too, the establishment of postgraduate educational programs such as pioneered by the University of Sydney (147) and Tufts University School of Medicine (148).”

“Further, the Montreal Statement on the Human Right to Essential Medicines in 2005 expressly linked the international right to health with a universal access to WHO essential medications (150). This statement, presented in November 2005 to a high level task force of the UN Human Rights Commission in Geneva, has a clear relevance to pain management, especially in the accessibility and affordability of opioids.

(A good part of the article deals with the politics of opioids, which I linked hypothetically to the war in Afghanistan in my blog article A venturesome view on the politics of suffering.) 

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