Consider this: More than 259 million prescriptions for opioid painkillers were issued in 2012; that’s at least one prescription for every adult in our country.
On the list of global morphine intake, the U.S.A. ranked fourth highest in milligrams received per person. African countries overwhelmed by cancer as well as other painful fatal illnesses – including AIDS – don’t even begin to surface until 30 countries down the list.
For as dire and ravaging as the national epidemic of painkiller abuse and overdose is, most of those living and dying in pain around the rest of the world face a mortifying absence of needed pain medication.
Crisis is relative
For patients equally battling chronic cancer pain, severe burns, bone fractures, diabetic nerve damage and even terminal illness in Africa, Asia and Latin America, prescriptions are usually no stronger than acetaminophen.
In 2013, domestic consumption of morphine skyrocketed 32 times higher than in 1964 – up to 79.9 mg per person. Elsewhere, morphine intake in Tanzania doubled, to just 0.15 mg per capita and India, to a mere 0.11 mg per patient.
As the New York Times described in an expose, those with diseases outside of the U.S. and Europe are not denied painkillers simply because of poverty. Rather, “Narcotics incite fear: Doctors fear addicting patients, law enforcement officials fear drug crime, and members of the government elite who can afford medicine for themselves are indifferent to the sufferings of the poor.”
Ethicist and palliative care physician Eric Krakauer calls this fear “opiophobia.”
The United Nations International Narcotics Control Board (INCB) has been blamed by some critics for the third world aversion to prescribing opioids, scaring authorities straight with statistics and rigid recommendations related to painkiller addiction.
To its credit, the INCB issued a 2010 report where it described “reform measures that have had a significant impact on the effective treatment of pain include extending the validity of prescriptions for opioid analgesics from seven to 28 days and allowing nurses to administer opioids in the absence of a doctor.”
This is an ironic contrast to recent U.S. legislation promoting reducing painkiller prescriptions down to seven day-doses.
What’s disconcerting is the rest of the world’s opiophobia comes largely from warnings and information provided by the INCB and the United States’ seemingly gluttonous proliferation and long-standing divergence from United Nations recommendations.
Finding a happy medium
The INCB provides oversight of international narcotics treaty compliance is for “selected countries.” The contrast could not be more pronounced between those selected countries that live in fear of opioids and those countries with an overreliance on potentially deadly painkillers.
If the extremes on both sides of the issue could find a middle ground of rational respect for the medical benefits and health hazards of opioids, there might be a lot less suffering in the future.
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About the author
Sovereign Health Group staff writer Kristin Currin-Sheehan is a mindful spirit swimming in metaphysical pools with faith as her compass. Her cover: a 30s-something Cinderella breadwinner of an all-sport blended family. Her repertoire includes writing poetry, lifestyle articles and TV news; editing, radio production and on-camera reporting. For more information and other inquiries about this media, contact the author at firstname.lastname@example.org.
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