Increasing worldwide access to medical opioids

As the medical world began to understand the bacterial nature of infection, development of the hypodermic syringe in the mid 1800s led to opioids becoming important in pain management. Yet, today, 80% of the world's population lack access to morphine, 1 Milani B Scholten W The world medicines situation 2011. Access to controlled medicines. World Health Organization, Geneva2011 Google Scholar a medicine included in WHO's first essential medicine list in 1977, 2 The selection of essential drugs: report of a WHO expert committee. World Health Organ Tech Rep Ser. 1977; 615: 1-36 PubMed Google Scholar whereas increases in opioid consumption have occurred in most high-income countries. 3 Hastie BA Gilson AM Maurer MA Cleary JF An examination of global and regional opioid consumption trends 1980–2011. J Pain Palliat Care Pharmacother. 2014; 28: 259-275 Crossref PubMed Scopus (50) Google Scholar Stefano Berterame and colleagues outlining this inequity and the continued absence of progress in improving access in The Lancet is a great step forward. 4 Berterame S Erthal J Thomas J et al. Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study. Lancet. 2016; (published online Feb 3.)http://dx.doi.org/10.1016/S0140-6736(16)00161-6 PubMed Google Scholar They share with the medical and worldwide communities data that are all too often restricted to the International Narcotics Control Board (INCB) annual reports and technical publications, and also share a new statistical analysis substantiating previous descriptive results. 5 Gilson AM Maurer MA LeBaron VT Ryan KM Cleary JF Multivariate analysis of countries' government and health-care system influences on opioid availability for cancer pain relief and palliative care: more than a function of human development. Palliat Med. 2013; 27: 105-114 Crossref PubMed Scopus (28) Google Scholar Use of and barriers to access to opioid analgesics: a worldwide, regional, and national studyUse of opioid analgesics has increased, but remains low in Africa, Asia, Central America, the Caribbean, South America, and eastern and southeastern Europe. Identified impediments to use urgently need to be addressed by governments and international agencies. Full-Text PDF