General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsU.S. consumes 84% of worldwide oxycodone and nearly 100% of hydrocodone opioids
Gleaned from The Nation The Real Reason Pot Is Still Illegal July 21-28, 2014 edition:
http://www.thenation.com/article/180493/anti-pot-lobbys-big-bankroll#
People in the United States, a country in which painkillers are routinely overprescribed, now consume more than 84 percent of the entire worldwide supply of oxycodone and almost 100 percent of hydrocodone opioids. In Kentucky, to take just one example, about one in fourteen people is misusing prescription painkillers, and nearly 1,000 Kentucky residents are dying every year.
IMPORTANT!
more at link (a superb article worth the read)
USA! USA! USA!
Comrade Grumpy
(13,184 posts)Here are a pair of links from the WHO and Human Rights Watch. It appears to be the latter:
http://www.who.int/medicines/areas/quality_safety/access_Contr_Med/en/
Access to Analgesics and to Other Controlled Medications
Although necessary, drug control regulations, if overly restrictive, can hamper access to controlled medicines for therapeutic use. A balance must therefore be struck between medical and regulatory requirements.
For over 50 years the focus has been on the prevention of abuse. This has led to overly strict rules or inappropriate implementation of the international drug control treaties in many countries. As a result, the medical use of controlled substances has been hampered and in some cases prohibited. Another consequence is that misconceptions have spread based on the unjustified fear that opioid medication may cause dependence or death in patients.
Many countries have neglected their obligation under the UN Conventions to provide sufficient access to analgesics. These obligations are reinforced by many international bodies, i.e. the International Narcotics Control Board (INCB), the United Nations Economic and Social Council (ECOSOC), and the World Health Assembly (WHA).
Severe under-treatment is reported in more than 150 countries, both developing and industrialized, accounting for about 80% of the world's population. Annually, up to 10 million people suffer from lack of access to controlled medications. Nearly 1 billion of those living today will encounter this problem sooner or later. Most of them will be pain patients, others will be suffering from other conditions. The impact of impaired access to these medications is extremely serious.
After being invited in 2005 by the Convention on Narcotic Drugs, ECOSOC and the WHA to study the feasibility of assisting countries improve access to opioid analgesics, WHO developed the Access to Controlled Medications Programme (ACMP) in consultation with the International Narcotics Control Board (INCB). The Programme aims to improve legitimate medical access to all medications controlled under the drug conventions.
http://www.hrw.org/news/2011/06/02/global-tens-millions-face-death-agony
Global: Tens of Millions Face Death in Agony
Palliative Care Neglected Worldwide
JUNE 2, 2011
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Community health worker Mary Njoki speaks to a mother of twins during a home-based care visit on March 6, 2010, in Mathare, a slum in Nairobi. Njoki taught the twins mother how to apply a medicine for their skin condition but has not been trained to assess pain and has no access to pain medicines.
© 2010 Brent Foster
RELATED MATERIALS:
India: Ensure Access to Pain Treatment
FEBRUARY 12, 2010 Press release
Kenya: Provide Treatment for Children in Pain
SEPTEMBER 9, 2010 Press release
Ukraine: Condemned to Excruciating Pain
MAY 12, 2011 Press release
Worldwide, palliative care needs are enormous, but many governments simply ignore them. There's no excuse for letting people suffer from severe pain when inexpensive medications are available to help them.
Laura Thomas, health researcher at Human Rights Watch
(New York) - Tens of millions of people worldwide are denied access to inexpensive medications for severe pain, Human Rights Watch said in a report released today.
The 128-page report, "Global State of Pain Treatment: Access to Palliative Care as a Human Right," details the failure of many governments to take even basic steps to ensure that people with severe pain due to cancer, HIV, and other serious illnesses have access to palliative care, a health service that seeks to improve quality of life. As a result, millions of patients live and die in great agony that could easily be prevented, Human Rights Watch said.
"Worldwide, palliative care needs are enormous, but many governments simply ignore them," said Laura Thomas, health researcher at Human Rights Watch. "There's no excuse for letting people suffer from severe pain when inexpensive medications are available to help them."
Experts estimate that 60 percent of those who die each year in low- and middle-income countries - a staggering 33 million people - need palliative care. In these countries, most cancer patients are diagnosed when they already have advanced disease and can no longer be cured. The only treatment option is palliative care. In high-income countries, palliative care needs are increasing with aging populations and the resulting higher cancer incidence.
The report is based on a survey of policy barriers to palliative care in 40 countries and an assessment of the availability of pain-relieving drugs worldwide.
Human Rights Watch found that in 35 of 192 countries reviewed, fewer than 1 percent of patients with moderate to severe pain from terminal cancer or HIV could get the strong pain medications they needed. These countries are concentrated in Sub-Saharan Africa, but some are in Asia, the Middle East, North Africa, and Central America.
Availability of strong pain medications is very limited in many of the world's most populous countries, Human Rights Watch found. At least 100,000 people die from cancer or HIV/AIDS each year without access to adequate pain treatment in countries such as China, India, Indonesia, Nigeria, Russia, and South Africa.
"My leg would burn like a chili on your tongue," Dilawar Joshi, a Nepali man with a bone tumor living in India told Human Rights Watch. "The pain was so severe I felt like dying. I was very scared. I felt that it would be better to die than to have to bear this pain. [I thought], just remove the leg, then it will be alright. Just get rid of the leg so I'll be free of pain."
The survey found multiple barriers to palliative care in most of the 40 countries surveyed. Three quarters do not have national palliative care policies, despite a World Health Organization recommendation to develop such policies. In most of these countries, healthcare workers are not adequately trained in pain management or palliative care, and in some, no training is offered at all. In 33 of the countries, the government imposes restrictions on prescribing morphine beyond the requirements of UN drug conventions.
Human Rights Watch found a number of bright spots. Colombia, Jordan, Romania, Uganda, and Vietnam have successfully undertaken comprehensive reform programs to improve access to palliative care. In these countries, government officials have worked with the medical community and civil society to identify and address barriers to palliative care.
The World Health Organization considers palliative care an integral component of cancer care and has urged countries to improve its availability. The 1961 Single Convention on Narcotic Drugs, to which 184 states are parties, requires countries to ensure the adequate availability of narcotic drugs for the relief of pain and suffering.
"Colombia and Uganda and the other countries that have worked to provide palliative care powerfully show that all countries can make progress," Thomas said. "The key ingredient is the political will to make these health services available and to relieve people's suffering."
Quotes From Patients and Healthcare Workers Interviewed by Human Rights Watch:
"Before I came [to Kenyatta National Hospital], I couldn't eat or breathe well [because of the pain]. Now that I have been given medicine [morphine], I can eat and breathe. I couldn't sit down, but now I can. I had pain for more than a month. I told the doctor and nurses [at another hospital] that I had pain. It took too long to get pain treatment... Here I got it immediately and started feeling well again."
- Christine L., an 18 year-old woman with Breast Cancer, Nairobi, Kenya.
"I would sleep maybe an hour and a half per night. I could take any number of sleeping pills [without effect]. With morphine, I can relax. This place [the palliative care unit] is heaven-sent..."
- Shruti Sharma, Hyderabad, a breast cancer patient, India
"Cancer is killing us. Pain is killing me because for several days I have been unable to find injectable morphine in any place. Please, Mr. Secretary of Health, do not make us suffer any more."
- A classified ad placed inEl Paísnewspaper in Cali, Colombia, on September 12, 2008, by the mother of a woman with cervical cancer
"I wanted to fall head down and be dead right away so it wouldn't hurt anymore."
- Vlad Zhukovsky, a cancer patient from Ukraine, describing a failed suicide attempt
"We have no pethidine, no DF-118 (dihydrocodeine) and no morphine.... We have children here with advanced HIV; some are in severe pain. The pain management for children with advanced HIV is not enough."
- Nurse, Bondo District Hospital, Kenya
"Doctors are fearful of everything to do with opioids."
- Oncologist, Jorda.
A Little Weird
(1,754 posts)Your examples show the under use. I am especially horrified to read about cancer patients not getting pain meds.
The overuse is hard to miss in the U.S. It is an epidemic here in Kentucky. My cousin died of an overdose of oxycodone. I know several people whose lives revolve around figuring out how to get more painkillers (and other prescription drugs too).
I am not a pot user but I am 100% in favor of legalization because I think it would reduce some of the painkiller abuse we see now. To me, pot seems to be a much better option.
hollowdweller
(4,229 posts)I believe there is a huge economic angle to prescription drug abuse in Appalachia at least.
For a lot of people if they can get a script for some sort of painkiller, or benzo's or either say they have adult ADD or get their kid on Adderal for add then they have pretty much upped their income by several hundred dollars a month.
In a lot of the areas where addiction is the worst there's no jobs or the pay is very low. Then people have no money for entertainment nor is there anything to do for entertainment had they the money. So the whole pill standard like the gold standard rules.
I've seen people getting painkillers for stuff like arthritis, or some bulging discs. They have an organic reason to get them but the pain isn't really that bad so they just sell them to make ends meet.
Tons of people around here od'ing. 2 people dead on my road cause of them. ER's that should be treating sick people full of OD's and most of the people either uninsured or Medicaid. LOTS of people with Hep C. Going to be an epidemic of liver cancer in 15 or 20 years.
LeftyMom
(49,212 posts)Comrade Grumpy
(13,184 posts)...there are countless reports of legitimate pain patients finding little or no access.
Ruby the Liberal
(26,219 posts)If a doctor is concerned that a patient is misusing, hells yeah they will cut them off. I still have most of my bottle of Oxy from my surgery in January and I won't take it unless there is a gun to my head. I *HATE* the way it makes me feel. My doc knows that, but every month when I go into the office, he asks me if I want a new script. I told him I will get with him if and when these ever expire. There are others that I know that have been cut off completely. When I asked, some were over doing it, and another was taking the exact script as written, but as it had been 6 months, they felt that she should have been weaning off by now (or something).
It all just depends.
Free the weed and you free the people. Including us cancer peeps.
CTyankee
(63,889 posts)it's good to have on hand...
Ruby the Liberal
(26,219 posts)Oxy made me meaner than a wet hen.
Not a bad option if you are still in the hospital and just want to be left alone so you can rest - tell them its time for the Oxy and regardless of the hour, its "dinner time". *poof*
I appreciate the heads up on another option to ask about - you know they LOVE recommendations. Heh. Seriously though, I asked the hospital to put Oxy on my 'allergy' list and I have a followup surgery in a few months. I will ask my Doc about that one to see if he approves. Tylenol sensitivity/toxicity/liver/whatever runs in my family so the list grows smaller. Be nice if the hospitals allowed MMJ (which works wonders for post-surgical pain) but its only 2014.
CTyankee
(63,889 posts)Ruby the Liberal
(26,219 posts)Thanks for the heads up!
LeftyMom
(49,212 posts)cali
(114,904 posts)I have this:
<snip>
Type II, formerly known as causalgia, has evidence of obvious nerve damage. Type II CRPS tends towards the more painful and difficult to control aspects of CRPS; type II scores 42 out of 50 on the McGill pain scale[6] (however there is seemingly little or no data pertaining to type I specifically here). In Type II the "cause" of the syndrome is the known or obvious nerve injury, although the cause of the mechanisms of CRPS Type II are as unknown as the mechanisms of Type I.
CRPS has the unfortunate honour of being described as the most painful long term condition (of those that have been tested), scoring 42 out of a possible 50 on the McGill pain scale, above such events as amputation and childbirth.[7]
<snip>
I have done everything possible to mitigate this condition. I exercise aerobically for an hour, 5-6 days a week. I do specific exercises with bands for my foot and ankle. I changed my diet. I lost 20 lbs in order to have less weight to bear. I meditate daily. I am not addicted. I don't take it everyday and I almost always take it just at night when the pain keeps me up or wakes me up. I have not upped my dosage in almost 3 years, and sometimes I have 4 or 5 good days/nights before it gets me again.
shenmue
(38,506 posts)johnnyreb
(915 posts)Ruby the Liberal
(26,219 posts)They are but one in a long line - alcohol/beer, private for-profit prisons, DEA/LEO - there are a LOT of industries threatened by MMJ whether it is decreased profits or budget cuts.
That said, there was an interesting article in the paper here about 3 weeks ago talking about the heroin epidemic that is exploding in the suburbs. Apparently, fentenol (spelling?) is the biggest problem, but general "opioids" are being blamed as well. Seems the street level hustlers are cutting the heroin with them and making it more dangerous than plain heroin. IIRC, it had to do with the body trying to process different substances, or those substances giving the same 'high' but working in the body against each other or similar. People in their 20s and 30s are ODing in startling numbers.
No one has ever ODd from smoking cannabis.
ReverendDeuce
(1,643 posts)I had an injury a couple of years back (a bad one) and they prescribed these. They worked well enough to dampen the pain, but the really amazing thing was how the opioids increased my productivity. I swear to God, I've never been able to focus on such singular tasks with such intensity before. I could bang out code which would otherwise take days in a matter of hours. I could just rip through tasks like nobody's business. Two years on, I am still amazed at some of the work I did that month while I was on the prescription.
I never had the urge to go and get more, but damn it if there aren't times I could use a mental boost like that...
cali
(114,904 posts)ReverendDeuce
(1,643 posts)The first day or two I was using them, I was stuck in the hospital and I felt really weird. Very sleepy but incapable of rest. Like my head was wrapped in gauze. When I got home, that's when the cracking good work started churning out. For hours I'd be able to focus on tasks.
My wife had them when she had surgery a year earlier. It just made her tired and nauseous.