Study shows access to palliative care limited to a few patients

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No access to morphine leads to the agonizing deaths of 26 million people a year, report says | Miami Herald

One specialist who has long warned that the US addiction crisis could spread internationally said the proposal for poor countries to avoid patented opioids was a "sensible" approach. The study was conducted by the Commission on Global Access to Palliative Care and Pain Relief, which included 61 authors from 25 countries. The limited supply of these drugs in some nations means millions of people throughout the world are faced with chronic unnecessary pain and spend their final days of life in agony. Over 25.5 million people, including 2.5 million children, globally die every year with serious health issues that require palliative care.

Another 35.5 million people a year have serious pain and suffering from those conditions but aren't dying, and most live in low- or middle- income countries.

Nearly 80% of deaths requiring palliative care in low-income countries are preventable with adequate prevention, treatment and care interventions.

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Addressing morphine access is even less costly. In Afghanistan, India and Nigeria, for example, less than 5 percent of pain management needs are met, according to the report. According to the report, off-patent, immediate-release morphine costs about 3 cents per 10 milligrams.

Researchers reported that out of the few hundred tons of morphine and opioids distributed around the world, less than 4 percent goes to low- and middle-income countries. It said inequity in access to essential pain relief and palliative care was one of the world's most striking injustices.

"The fact that access to such an cheap, essential, and effective intervention is denied to most patients in low-income and middle-income countries and in particular to poor people.is a medical, public health, and moral failing and a travesty of justice", the authors of the paper write. She co-chaired a Lancet-appointed global commission that spent three years studying the disparity and what she calls "the moral obligation" to help. "While stock-outs are no longer a problem for palliative care in Kerala, [at other places] there is a near total lack of access to morphine to alleviate pain and suffering", Dr Rajagopal said. "Unbalanced laws and excessive regulation perpetuate a negative feedback loop of poor access that mainly affects poor people", they write in the paper.

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"Oral morphine in palliative care in most countries is nonexistent".

And they have a name for the fear of overdose deaths: opiophobia.

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