Over-Regulation of Opioids Is Resulting in Untreated Cancer Pain for Millions of Patients Worldwide
The results from the European Society for Medical Oncology (ESMO)-led Global Opioid Policy Initiative (GOPI) project show that due to a lack of access to essential opioids, more than 4 billion people—over half the world’s population—live in countries where regulatory barriers, which aim to stem opioid abuse, leave cancer patients suffering in severe pain. The survey results are published in Annals of Oncology.
The survey, conducted in Africa, Asia, Latin America and the Caribbean, and the Middle East, evaluated the availability of the seven opioid medications considered crucial for the relief of cancer pain by the World Health Organization (WHO) Model List of Essential Medicines and the International Association for Hospice and Palliative Care. The medicines included codeine, oral oxycodone, transdermal fentanyl, immediate and slow-release oral morphine, as well as injectable morphine, and oral methadone.
According to the report, while opioids are critical to the effective relief of cancer pain, “in some countries, pain relief is hampered by the lack of availability or barriers to the accessibility of opioid analgesics.”
Pain Is a Barrier to Quality of Life
While there are problems with the supply of opioids in many countries, the study found that the main issue is over-regulation, which limits the ability of physicians, nurses, and pharmacists to prescribe and administer them for legitimate medical use. “Preventing drug abuse is important,” wrote the study authors, “but it should not hinder patients’ ability to receive the care they need and deserve.” According to the report, excessive regulatory restriction makes it almost impossible for many patients with cancer to achieve relief from moderate and severe cancer pain and undermines their quality of life.
Finding Solutions
To improve accessibility to opioids for patients with cancer pain, GOPI members are partnering with other key civil society and intergovernmental agencies to reform regulations and promote the education of clinicians and consumers in the effective and safe use of opioid medications for cancer pain. The report cites examples of how international efforts in advocacy, education, and regulatory reform have already resulted in meaningful progress in many countries, including Romania, Hungary, the Czech Republic, Serbia, Armenia, Georgia, Columbia, Guatemala, Uganda, Kenya, Vietnam, and the Ukraine.
The survey was self-funded by the coordinating partner organizations. The study authors reported no potential conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
