E-drug: Drug estimates and treatment of pain
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Dear e-druggers,
The international drug conventions require countries to submit ahead
of time the estimates/assessments of their yearly requirements for
narcotic drugs and psychotropic substances to the International
Narcotics Control Board (INCB).
However, some countries do not have reliable systems that enable them
to work out appropriate estimates. They may rely on past consumption
data. But past consumption is not an assessment of the real needs.
Some drugs may be in oversupply and end up on sale in parallel
markets or other illicit channels while other drugs may be out of
stock for a period of time or not adequately prescribed because of
uncertainty of their availability by doctors or other reasons.
Some essential drugs, such as morphine (especially oral form) are
highly underutilized in many countries. The World Health Organization
has been encouraging, since mid 1980s, the use of oral morphine for
the control of certain types of pain. As a consequence, morphine
utilization has increased ten times worldwide. However, according to
INCB 2001 Report, most of this increase involves a limited number of
European, North American and few other economically developed
countries.
The problem is not economic, because morphine is very cheap, but may
be related to training, prescribers attitudes, the control system
etc. I know of some countries where morphine has not been imported or
manufactured for several years.
I am preparing, as a consultant for a UN agency, guidelines for
estimating the need for narcotic drugs and psychotropic substances.
I would appreciate if you could share with me some of your
experiences in your countries in this matter. Methods used to assess
real needs.
Furthermore, since millions of people in the world are suffering,
needlessly, from severe chronic pain that could be alleviated (eg
cancer patients, the terminally ill etc), I would appreciate to learn
of practical experiences (sensitization of prescribers or other
steps) that may lead or have led to improved utilization of morphine
or other pain control drugs.
Thank you for your contributions.
Dr. Abdullahi Elmi
Isutaw Consultants and
Coordinator of the Somali Group for Rational Use of Drugs (SGRUD)
Abdullahi Elmi <somali_drugs@yahoo.com>
[Responses to this message could also help people implementing
programs for the care of AIDS patients who have expressed interest in
access to morphine for treatment of pain. BS]
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