Opioid Abuse vs Opioid Need: A Global Injustice

opoidIt is no big secret that prescription painkillers—opioid—use is a major problem in the United States.  While these powerful narcotics are important—and necessary—for many people who have chronic pain, the are widely abused in the United States. Unfortunately, the opposite appears to be true in other parts of the world, other parts of the world where drugs like these are severely needed but nearly absent.

While health officials in countries like India, Mexico, Russia are reluctant to prescribe such painkillers—out of fear for legal issues, even when they believe the drugs are necessary—health officials in countries like Kenya have only very recently authorized the production of such opioid analgesics.  And, in fact, Kenyan officials have only sought to engineer such medicines after receiving widespread criticism that drugs like morphine were only available in 7 of the country’s 250 public hospitals.

The World Health Organization estimates that approximately 5.5 billion people live in countries with very low or even nonexistent access to these controlled medicines needed for the treatment of moderate to severe pain.

According to the Human Rights Watch advocacy group, drugs like these are typically restricted and usually not available at all to people in most poor- and middle-income countries, not even for patients with terminal cancer, AIDS, or terrible wounds of war!

Diederisk Lohman is the associate director of the health and human rights division for the advocacy group.  He advises: “We shouldn’t forget that these are medicines that are really essential in our health care systems,” adding that “While clearly there are issues with some prescribing practices, there’s also clearly a risk to vilifying these medicines.”

Unfortunately, he warns, in some countries a simple clerical error when prescribing drugs like morphine can lead to criminal investigations.  He cautions that “the fear associated with prescribing a medicine under strict scrutiny makes physicians afraid.

Similarly, Harvard School of Public Health visiting scientist and palliative care expert, Afsan Bhadelia, remarks that there is a massive international misconception about the need for increased control of opioid medications, which has led to tighter regulation.

She laments on this great injustice: “People do not have access to pain control for basic surgery [and] are going into the operating room and not having anyone mitigate their pain.”

Basically, it can be argued that many countries throughout the world suffer from a lack of painkilling narcotics as, at least, an indirect result of a community struggling from vast opioid abuse in the United States.



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