In the United States, opioid addiction is an epidemic. We are all to familiar with stories of an over-prescription of pain killers leading to addiction but our fear of opioids is also causing millions to suffer in pain.
Michael Plant, a PhD candidate at the University of Oxford, addresses the under-prescription of opioids in middle- and low-income countries:
The World Health Organisation estimates that 40 million people are in need of palliative care every year and of those who need it, only 14 percent receive the care.
Access to essential pain relief is distorted. A Lancet 2017 study reported that the United States has access to 31 times as much pain relief needed by patients while Haiti receives less than one percent of what is needed. According to the study, 25 million people die in pain every year without access to pain relief.
More shocking is that the issue here isn’t money. It’s policy. Restrictive regulations fueled by a fear of unintended opioid use and lack of awareness are building barriers for people who desperately need pain relief to receive it. Countries have a tough balancing act of insuring necessary access to pain relief while avoiding an abuse crisis.
Uganda answers this balancing act by distributing bottles of morphine diluted in water to help prevent addiction. A person would have to drink gallons to get high. As reported in the New York Times, these bottles are given to those in need by a private charity, Treat the Pain and the government absorbs the cost so it is free for patients.
This isn’t a new solution, Treat the Pain partnered with Hospice Africa, started distributing oral morphine solutions in 2011. Uganda has ranked 35th out of 80 countries and second in Africa in the 2015 Quality of Death Index from the Economist Intelligence Unit. So why aren’t other countries following suit? Uganda is inspiring laws and policies for several countries but the low-cost solution is not popular largely because of lack of awareness and infrastructure and frustratingly because of the fear of the word 'opioid'.