National opioid quota reform so morphine reaches cancer patients
Most of the world's people who die in cancer pain have no access to morphine, a drug that costs pennies, because of restrictive national rules. Fixing the rules, not inventing new drugs, is the answer.
The Lancet Commission on Global Access to Palliative Care and Pain Relief estimated that the great majority of the world's need for opioid analgesia in serious illness goes unmet, concentrated in low- and middle-income countries. Barriers are regulatory: unrealistic national import estimates submitted to the International Narcotics Control Board, prescribing restricted to a few specialists, short prescription limits, and fear of prosecution. A country-level reform package with realistic quota estimation, expanded prescriber lists, and prescribing training could change this in years.
- Pain relief and palliative care are unavailable to most · Most people who die of cancer worldwide do so without adequate pain relief.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.