Access to Controlled Medications Programme

Approximately 80% of the world’s population has either no or insufficient access to treatment for moderate to severe pain. This is true for both developing and industrialized countries. Each year tens of millions of patients suffer moderate to severe pain without treatment:

• 0.8 million end-stage HIV/AIDS patients
• about 4 million terminal cancer patients
• patients suffering injuries, caused by accidents and violence
• patients recovering from surgery
• women in labour
• patients with chronic illnesses
• paediatric patients.
  • Access to controlled medicines

To protect themselves against the harms of drug dependence, many countries introduced drug control measures, but in doing so impacted the availability and use of controlled medicines for medical use.

In practice, lack of access affects all controlled medicines on the World Health Organization (WHO) Model List of Essential Medicines. Because of their status as essential medicines, their availability for medical treatment is part of the human Right to Health, as defined in the International Covenant on Economic, Social and Cultural Rights.

Many factors contribute to the lack of access to controlled medicines. There is a need for greater awareness among policy makers, health-care professionals and the general public to dispel the myth that opioid analgesics (i.e. pain killers derived from opium, such as morphine) will do harm to patients and cause dependence. The fear of dependence upon pain treatment is largely unfounded, as almost all patients are able to stop their opioid medication at the end of their treatment with no long-lasting effects. Although substitution treatment does not terminate dependence, it removes most of the detrimental health effects for the patient, as well as the harmful impact of drug dependency on a society. Ergometrine, which can be used in obstetrics is often unavailable for use in childbirth. Although not a drug of abuse it can be used as a starting material for the synthesis of such drugs.