Pain Treatment: INCB Calls for Greater Access to Opioid Medicines in Developing World

As part of its 2007 Annual Report, released Wednesday, the International Narcotics Control Board (INCB) issued a press release saying that "ensuring access to pain treatment medicines is vital and possible." Millions of people around the world are suffering chronic and acute pain because narcotic pain medications are not being sufficiently used, the group said.

The INCB is a 23-member independent commission that works with the UN Office on Drugs and Crime (UNODC), its Commission on Narcotic Drugs (CND) and other international organizations to monitor implementation of the series of international treaties that form the legal backbone of the global prohibition regime. While its remit includes ensuring adequate supplies of drugs are available for medical and scientific uses, it spends most of its resources trying to prevent any deviations from the global prohibitionist drug policy status quo. (See related story here.)

According to the INCB, while global consumption of opioid pain relievers has more than doubled in the past decade, the vast majority of that growth has occurred in Europe and North America, which together accounted for 89% of global morphine consumption in 2006. By contrast, the 80% of the global population that lives in developing countries consumed only 6% of the morphine supply. In some countries, access to morphine is "extremely low and almost non-existent for most of the population," the group said.

The situation is similar for some other opioids such as fentanyl and oxycodone. In 2006, Europe and North America accounted for 96% of global fentanyl consumption and 97% of oxycodone, the group reported.

The lack of sufficient access to these powerful pain medications is "due to diverse interrelated factors such as inadequate medical education of health professionals and lack of knowledge and skills in pain treatment, public attitude, regulatory impediments or economic constraints," the INCB said. In a slap at proposals to deal with Afghan opium production by licensing it and diverting it into the legal medicinal market, as the Senlis Council has suggested, the INCB said global supply was at high levels and not the problem.

"Suggestions to further increase the supply of raw materials by using opium from the illicit production in Afghanistan do not address the cause of the problem. Governments should focus on measures to increase demand for pain-relief medication in line with the recommendations of INCB and WHO," said INCB President Philip Emafo.

The INCB said it urged governments to identify obstacles to adequate access to narcotic pain medications and to take steps to improve their availability. It also announced that, in consultation with the World Health Organization (WHO), it had created the Access to Controlled Medications Program to address identified impediments. The group urged all governmental and concerned international organizations to cooperate with the WHO, and called on governments to pony up some cash to pay for it.