Pain that can't be killed

Drugs Banned, Many of World’s Poor Suffer in Pain
 By DONALD G. McNEIL Jr.
Published: September 10, 2007
New York Times

This article, which appeared in the New York Times, chronicles the struggle that patients in Sierra Leone suffer from the lack of drugs. But the drugs that these patients don’t have access to are cheap and easy to produce. These drugs are morphine and other opiate derivatives. Patients in Sierra Leone and other African countries who are suffering through painful diseases do not have access many forms of palliative care. These patients usually don’t have access to the medical care that could have prevented their disease’s progression to such a stage. These early interventions tend to be expensive and most people cannot afford them, or even if they could, there is no medical facility nearby that could administer the treatment.

The lack of morphine leaves patients who are diagnosed with cancer, AIDS, and nerve damage with constant and intense pain. There is even a company in India that is producing oral morphine for only 1.7 cents a pill. So the simple question is: Why isn’t morphine being given to these patients? That is when politics meets healthcare.

It is a well known fact that opiates are highly addictive. However under proper medical supervision, these medications can be highly effective and not have intense adverse effects. This is why the government of Sierra Leone and some other African nations do not allow the importation or domestic growth of opiates. They believe that because there is a lack of widespread medical care and that because opiates could begin a huge addiction epidemic, no morphine should be administered.

Even though the outcome may seem a bit extreme, the logic of not bringing in opiates seems somewhat rational. Furthermore, the governments of these nations have relatively limited funds which tend to be directed to treatments for more immediate diseases such as diarrhea, pneumonia, tuberculosis and malaria. Yet there should be a better solution that letting millions suffer in pain. In the west, palliative care is almost a given birthright. People expect to not suffer disease in pain, and when they have to suffer it is only for short time. People in these nations never have had access to these medications, so the assumption that morphine will turn into an epidemic is just that, an assumption.

The words of the founder of a hospice in Sierra Leone resounded particularly strongly, “How can they say there is no demand when they don’t allow it?” he asked. “How can they be so sure that it will get out of control when they haven’t even tried it?”