Medicines and the drug control treaties: is buprenorphine for opioid addiction at risk of being lost?
Over the past century, a worldwide system for the control of drugs with abuse potential has developed through the adoption of a series of international treaties. The important multilateral conventions currently in force are the United Nations Single Convention on Narcotic Drugs, 1961 (Single Convention), the United Nations Convention on Psychotropic Substances, 1971 (Psychotropic Convention) and the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988. From the beginning, the aim of these drug control treaties has been to control the abuse and trafficking of substances with abuse potential while assuring that the availability of these drugs for medical and scientific purposes is not unduly restricted. There is activity in the World Health Organization and the International Narcotics Control Board to determine whether the international control of buprenorphine, a partial mu-opioid agonist used as an analgesic and for the treatment of opioid addiction, should be changed from the Psychotropic Convention to the Single Convention. This change would result in the classification and regulation of buprenorphine as a narcotic drug rather than a psychotropic substance. Such a move is unwarranted medically and scientifically and would provoke increased controls on buprenorphine that would fundamentally disrupt the medical practice of pain management and opioid replacement therapy around the world. The negative impact of inappropriate regulatory controls when licensed medicines come under such scrutiny are described.
Costa E Silva
J A
JA
The International Center for Mental Health Policy, New York University Medical School, New York 10016-9196, USA. jacs@vector.com.br
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D004335:Drug and Narcotic Control / Q000266:history / Q000331:legislation & jurisprudence*; D049673:History, 20th Century; D006801:Humans; D007391:International Cooperation / Q000266:history; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D014944:World Health Organization
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D001569:Benzodiazepines; D002047:Buprenorphine