Millions die suffering amid global opioid gap, report says

Rodiano Bonacci
Ottobre 13, 2017

Nearly 80% of deaths requiring palliative care in low-income countries are preventable with adequate prevention, treatment and care interventions.

Something as basic as pain management reaches too few, too late.

The study, conducted by The Lancet Commission on Global Access to Palliative Care and Pain Relief, found that the needs for pain management and palliative care remain unmet in many developing nations. A new report published online in The Lancet Thursday says that worldwide, more than 25.5 million people a year (almost half of all deaths in 2015), including 2.5 million children, die with serious physical and psychological suffering as a result of disease, injury or illness.

"More than 80% of people needing palliative care live in low- and middle-income countries". About 25.5 million adults and 2.5 million children are among those who die without adequate relief.

Nearly 80% of deaths requiring palliative care in low-income countries are preventable with adequate prevention, treatment and care interventions, said Professor Felicia Knaul, co-chair of the Commission from the University of Miami, in a statement. The study said that though off-patent affordable immediate-release morphine for pain relief costs as little as three cents per 10 mg and is an essential component of palliative care, less than one per cent of the world's supply went to low-income countries where the need was the greatest.

In Kerala, which has 170 institutions providing palliative care, a palliative care policy was introduced in 2008, Dr Rajagopal said. Providing pain relief for all those with medical need could cost as little as $145 million. Today each gram panchayat has a palliative care nurse providing home visits to every bed-bound patient once a month.

-Countries should use cheap, immediate-release oral and injectable morphine for severe pain.

Dr Rajagopal, who is one of the five lead authors of the study, said the poor budgetary allocation came despite Parliament changing its draconian Narcotic Drugs and Psychotropic Substances Act, which was a major hindrance to pain relief access.

In numerous countries, oral morphine isn't available, even though it's affordable. Pallium India had earlier joined nine palliative care organisations from around the world.

The absence of morphine, essential in palliative and end-of-life care, in many low and middle-income countries is "emblematic of the most extreme inequity in the world", the report states.

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