To state the obvious: 1) most advanced cancer patients have pain, and 2) we have excellent pain medications which can effectively treat more than 90% of cancer pain. Therefore, most patients with cancer receive proper prescriptions for pain. Obvious, yes? True? No.
In Europe, Australia and North America narcotic analgesics are widely available, and frequently prescribed. While there is access, many patients, particularly those in certain groups such as seniors and those with limited financial means, often receive insufficient doses and amounts, which only superficially address pain needs. Nonetheless, this partial success means that high income Countries use up to 95% of the world supply of morphine.
Tragically, the remaining world population has its pain treated with the remaining 5%.
India is the world’s largest manufacturer of morphine, but the drug is almost unavailable in that country. In much of the world archaic poorly designed laws designed to limit abuse fail to achieve that goal but instead limit access for patients in critical need.
The vast majority of narcotics prescribed to treat pain are not diverted from their therapeutic goal and do not contribute to dependence or addiction. On the other hand, ineffective, poorly designed efforts in global drug trafficking wars markedly reduce access for most patients, with cancer patients collateral victims of friendly fire. This is a global problem and will require a world effort to stop the agony.
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