Re: Opioid prescribing is rising in many countries
'Opiod prescribing is rising in many countries' claim Smith et al. (2019), with the result that opioid prescription and use are 'widespread'. Whilst this may be true in high income countries, we must remember that lack of appropriate opiate pain relief, in particular for those at the end of life, is a continuing crisis in low and middle income countries (LMICs).
According to the Global Atlas of Palliative Care (2014), eighty per cent of the world’s population lacks adequate access to opioid medications for pain control. This contributes to the ongoing burden of serious health-related suffering for those at the end of life (Knaul 2017). Whilst issues of opiate misuse and over-prescribing are a serious problem for high income countries, any debate on this issue should be clearly situated within this context. Otherwise we risk further exacerbating the many barriers that already exist to increased uptake of opiates in LMICs.
Knaul FM Farmer PE Krakauer El et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. Lancet. 2017; (published online Oct 11.)
Smith et al., Opioid prescribing is rising in many countries BMJ 2019;367:l5823
Rapid Response:
Re: Opioid prescribing is rising in many countries
'Opiod prescribing is rising in many countries' claim Smith et al. (2019), with the result that opioid prescription and use are 'widespread'. Whilst this may be true in high income countries, we must remember that lack of appropriate opiate pain relief, in particular for those at the end of life, is a continuing crisis in low and middle income countries (LMICs).
According to the Global Atlas of Palliative Care (2014), eighty per cent of the world’s population lacks adequate access to opioid medications for pain control. This contributes to the ongoing burden of serious health-related suffering for those at the end of life (Knaul 2017). Whilst issues of opiate misuse and over-prescribing are a serious problem for high income countries, any debate on this issue should be clearly situated within this context. Otherwise we risk further exacerbating the many barriers that already exist to increased uptake of opiates in LMICs.
Knaul FM Farmer PE Krakauer El et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. Lancet. 2017; (published online Oct 11.)
Smith et al., Opioid prescribing is rising in many countries BMJ 2019;367:l5823
World Palliative Care Alliance. Global Atlas of Palliative Care. April 2014. https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf
Competing interests: No competing interests