The War On Drugs Versus Developing World Pain Relief


I’ve noted on a few occasions the tensions between the policy objectives of the “war on drugs” and people’s legitimate desire to secure relief from intense pain. What I’ve written before about this has been about rich countries and regulatory/logistical hurdles to obtaining effective opioid pain relievers. But as Charli Carpenter writes, there’s also a developing world version of the problem in which actual shortfalls of medicine are the issue:

However, a significant (and solvable) aspect of the problem is simply the relationship of supply to demand: the need for analgesics like morphine far outweighs the available supply. In part, this is due to the fact that such analgesics are produced from opium, the sap of the poppy. Since the same plant extract can also be used to produce heroin, a significant amount of political effort is now being expended worldwide to actually inhibit, rather than encourage, opioid production. This fuels shortages of analgesics.

Writing in the Journal of Epidemiology and Community Health, Amir Attaran and Andrew Boozary suggest a seldom-mentioned way to increase supply: re-framing Afghanistan’s poppy problem as “an opportunity for global public health.” In short, the authors suggest pro-government forces abandon efforts to eradicate Afghan poppy cultivation and instead redirect them toward the production of licit opiods for analgesic pain medication.

For the vast majority of human history, there was really very little one could do about the problem of chronic pain. Consequently, most cultures have come to valorize stoical perseverance in the face of pain as a major virtue. The reality, however, is that few things are more misery-inducing than prolonged stretches of pain. Ameliorating severe pain where possible can provide giant gains in human welfare relative to more conventional goals like boosting incomes and measured GDP.