Opioid inaccessibility and its human consequences: reports from the field.
Strong opioids such as morphine are rarely accessible in low- and middle-income countries, even for patients with the most severe pain. The three cases reported here from three diverse countries provide examples of the terrible and unnecessary suffering that occurs everyday when this essential, inexpensive, and safe medication is not adequately accessible by patients in pain. The reasons for this lack of accessibility are explored, and ways to resolve the problem are proposed.
Krakauer
Eric L
EL
Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Wenk
Roberto
R
Buitrago
Rosa
R
Jenkins
Philip
P
Scholten
Willem
W
D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology; D000328:Adult; D000701:Analgesics, Opioid / Q000600:supply & distribution* / Q000627:therapeutic use; D003906:Developing Countries; D004417:Dyspnea / Q000188:drug therapy; D017809:Fatal Outcome; D005260:Female; D006297:Health Services Accessibility; D003932:Heroin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000600:supply & distribution* / Q000627:therapeutic use; D009362:Neoplasm Metastasis; D010051:Ovarian Neoplasms / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy*; D010166:Palliative Care; D028701:Patient Rights; D011471:Prostatic Neoplasms / Q000473:pathology / Q000503:physiopathology; D013405:Suicide; D019452:Terminally Ill
D000701:Analgesics, Opioid; D003932:Heroin; D009020:Morphine