Intended for healthcare professionals

Observations War on Drugs

Reasons for drug policy reform: millions of people are left with untreated pain

BMJ 2017; 356 doi: (Published 19 January 2017) Cite this as: BMJ 2017;356:j309
  1. Katherine Pettus, advocacy officer
  1. International Association for Hospice and Palliative Care, Houston, TX 77007, USA
  1. kpettus{at}

Because of policies to prevent illicit drug use, patients in most of the world lack palliative care and suffer severe untreated pain, writes Katherine Pettus

More than five billion people—80% of the world’s population— live in countries where there is little or no access to opioid medicines such as morphine to treat moderate to severe pain.1 The World Health Organization’s list of essential medicines includes opioid analgesics,2 which also fall within the scope of the 1961 UN Single Convention on Narcotic Drugs, a treaty enacted to control the global supply of substances with potential for non-medical use.3

The independent quasijudicial International Narcotics Control Board monitors treaty compliance by approving national annual estimates of demand for controlled medicines.1 However, many countries submit inadequate estimates to meet clinical need, a situation the board is remedying through national and regional workshops. …

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