We've discussed "opioid phobia" before, in reference to the burgeoning backlash against painkillers in the States due to the unfortunate rise of Oxycontin as a bad, bad influence. However, the situation is far worse elsewhere in the world, where "opioid phobia" is preventing the use of morphine in a vast array of cases, amongst dying cancer patients and injured children alike. As the NY Times reports, these people wind up suffering unduly, despite the fact that morphine is relatively cheap, primarily due to out-of-date fears about - get this - morphine's addictive properties. Hint: if the patient is dying in excruciating pain, addiction is truly not the issue.
The World Health Organization estimates that 4.8 million people a year with moderate to severe cancer pain receive no appropriate treatment. Nor do another 1.4 million with late-stage AIDS. For other causes of lingering pain — burns, car accidents, gunshots, diabetic nerve damage, sickle-cell disease and so on — it issues no estimates but believes that millions go untreated.
Figures gathered by the International Narcotics Control Board, a United Nations agency, make it clear: citizens of rich nations suffer less. Six countries — the United States, Canada, France, Germany, Britain and Australia — consume 79 percent of the world’s morphine, according to a 2005 estimate. The poor and middle-income countries where 80 percent of the world’s people live consumed only about 6 percent.
That's just the background. The practical details on the ground are a lot harder to stomach:
At pain conferences, doctors from Africa describe patients whose pain is so bad that they have chosen other remedies: hanging themselves or throwing themselves in front of trucks.
And:
Doctors in developing countries, he explained, often have beliefs about narcotics that prevailed in Western medical schools decades ago — that they are inevitably addictive, carry high risks of killing patients and must be used sparingly, even if patients suffer.
Apparently in some of these countries, the fear of drug abuse - by clinic staff, for instance, who might appropriate morphine for nefarious purposes - outweighs the palliative benefits morphine can offer. One wonders if this ultimately isn't the kind of thing that large scale philanthropy is going to have to sweep in and deal with, since the will of individual governments hardly seems up to the task.
But yeah, one more reason to thank your lucky stars if you're living in the wealthy parts of the world.
