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The amendments to the Narcotic Drugs and Psychotropic Substances (NDPS) act are expected to improve access to pain medicines for millions of Indians suffering from chronic pain due to cancer and other debilitating conditions. Every since the NDPS act came into force in 1985, there has been a huge hue and cry against this regulation that aims to control drug misuse while leaving cancer patients without access to opioids for managing cancer pain. While the drug has been available on prescription at major cancer hospitals in metro cities, majority of the patients have been denied access due to complicated regulations and issues related to knowledge and attitudes towards pain relief and opioids among health professionals and the public. This has been ironic for a country that lists morphine as an essential drug. Physicians in India have been apprehensive about addiction potential and cumbersome legal paperwork needed to acquire morphine for their patients.
Morphine is inexpensive, safe, effective, and easily administered orally and remains the principal treatment for management of chronic pain in palliative care programs. India has been the leading licit producer of opium to the world market for several decades, accounting for over 90 per cent of global production even though its own citizens were being denied opioids for terminal illnesses (1). The present amendment is expected to change this scenario and has been welcomed by patients and prescribers alike.
However, overcoming regulatory barriers is only a part of solution and a lot needs to done to improve the current state of affairs. Even though the Medical Council of India has introduced palliative care as a postgraduate specialization of medicine in 2011, as of now the course is being offered at only one centre in the country with an annual intake of 2 students (2). Now that the law has been amended, educating medical practitioners and helping them gain expertise with the use of morphine for chronic pain management should be an important goal. Also elimination of irrational fears of addiction to opioids is required on the part of health professionals as well as patients and their families.
Re: Indian parliament votes to increase access to morphine
The amendments to the Narcotic Drugs and Psychotropic Substances (NDPS) act are expected to improve access to pain medicines for millions of Indians suffering from chronic pain due to cancer and other debilitating conditions. Every since the NDPS act came into force in 1985, there has been a huge hue and cry against this regulation that aims to control drug misuse while leaving cancer patients without access to opioids for managing cancer pain. While the drug has been available on prescription at major cancer hospitals in metro cities, majority of the patients have been denied access due to complicated regulations and issues related to knowledge and attitudes towards pain relief and opioids among health professionals and the public. This has been ironic for a country that lists morphine as an essential drug. Physicians in India have been apprehensive about addiction potential and cumbersome legal paperwork needed to acquire morphine for their patients.
Morphine is inexpensive, safe, effective, and easily administered orally and remains the principal treatment for management of chronic pain in palliative care programs. India has been the leading licit producer of opium to the world market for several decades, accounting for over 90 per cent of global production even though its own citizens were being denied opioids for terminal illnesses (1). The present amendment is expected to change this scenario and has been welcomed by patients and prescribers alike.
However, overcoming regulatory barriers is only a part of solution and a lot needs to done to improve the current state of affairs. Even though the Medical Council of India has introduced palliative care as a postgraduate specialization of medicine in 2011, as of now the course is being offered at only one centre in the country with an annual intake of 2 students (2). Now that the law has been amended, educating medical practitioners and helping them gain expertise with the use of morphine for chronic pain management should be an important goal. Also elimination of irrational fears of addiction to opioids is required on the part of health professionals as well as patients and their families.
References
1. United Nations International Narcotics Control Board. Narcotic Drugs: Estimated World Requirements for 2013-Statistics for 2011 [Internet]. 2013 [cited 2014 Feb 25]. Available from: http://www.incb.org/documents/Narcotic-Drugs/Technical-Publications/2012...
2. Medical Council of India. Search Colleges & Courses [Internet]. 2014 [cited 2014 Mar 1]. Available from: http://www.mciindia.org/InformationDesk/CollegesCoursesSearch.aspx
Competing interests: No competing interests