For decades, the World Health Organization has designated pain treatment as a fundamental human right. Nonetheless, about 75 percent of the global population still doesn’t have access to basic pain relief medications, according to a new report from United Nations researchers — which means that about 5.5 billion people may suffer in pain if they become chronically or terminally ill.
Human rights scholars consider the uneven access to effective pain medication to be “one of the most neglected realms of global public health.” Even as palliative care has advanced, billions of people around the world continue to needlessly suffer in the final stages of painful diseases like AIDS or cancer. And dealing with chronic pain can also lead to higher rates of psychological distress and disability.
The new report, which was prepared by the International Narcotics Control Board (INCB), documents where pain medication is currently concentrated. More than 90 percent of the world’s morphine is consumed by just 17 percent of the global population, mostly Westerners living in wealthy places like the U.S., Canada, Australia, and Western Europe. Meanwhile, even as the developing world has recently seen a rise in the incidence of cancer, there aren’t many opioids left for them.
This disparity may even be in violation of international human rights laws. More than five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs — a treaty that requires countries to work on combating illegal narcotic abuse, as well as expand access to the narcotic drugs that are necessary for pain relief.
But, thanks to years of policy influenced by propaganda about drugs, most countries have focused only on the first part of that mandate. Groups like Human Rights Watch have carefully tracked the unintended consequences of severely restricting opioids: In many countries, that’s kept essential pain medications out of reach of cancer patients. As Al Jazeera recently reported, struggling patients have essentially become collateral damage in the War on Drugs.
“Governments must strive to achieve a well-functioning national and international system for managing the availability of narcotic drugs and psychotropic substances that provides relief from pain and suffering by ensuring the safe delivery of affordable drugs to those patients who need them while preventing overprescription and the diversion of drugs for the purpose of abuse,” the INCB report concludes.
Figuring out how to balance public health concerns with drug policy isn’t always so straightforward. Here in the United States, for instance, federal officials cracked down on Americans’ access to painkillers in order to prevent illegal opioid abuse — which simply led to an uptick in the abuse of a different type of narcotic. Now that prescription pills are harder to get, more Americans are turning to heroin. Overdose deaths from heroin have quadrupled since 2000, an epidemic that is ravaging rural areas of New England.
Health experts continue to advocate on behalf of pain relief for impoverished patients, which they say is an issue in at least 160 counties around the world. One recent report from a group of oncologists lamented the “global pandemic of untreated cancer pain.” In 2010, several medical organizations launched the Global Access to Pain Relief Initiative, which is working to make pain medicines universally available by 2020.