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Sickening truth about this global drug map

THIS week, US President Donald Trump promised to declare a national emergency on opioid use, after a White House Commission warned overdose deaths created a "September 11th every three weeks".

The synthetic drugs are widely prescribed in the US, Canada and Australia as a way to alleviate myriad chronic pain symptom, but they're highly addictive.

The rate of overdoses in Australia has doubled in the 10 years from 2005 to 2015 but in the United States, the magnitude is far more severe.

Opioid overdoses claim the lives of approximately 142 Americans every day.

However, there's another side of the crisis that can't be overlooked - and the findings of a global commission into distribution of opioids prevents a confronting reality.

This map has been distorted to represent opioid use around the world. Picture: The Lancet
This map has been distorted to represent opioid use around the world. Picture: The Lancet

The report, published in The Lancet, reveals while rich countries like the United States are struggling with an opioid epidemic, millions of people around the world are dying in a considerable degree of preventable pain.

It examines the case study of a man known as Mr S, from the south of India, who was suffering "crippling pain" from lung cancer.

He had to commute several hour by bus to see his doctor who told the commission his patient's "body language revealed the depth of the suffering".

He gave Mr S morphine, among other things, and said the difference was significant.

"A couple of hours later, he surveyed himself with disbelief. He had neither hoped nor conceived of the possibility that this kind of relief was possible," the doctor said.

However, when Mr S returned the next month, the clinic was out of stock.

"Mr S told us with outward calm, 'I shall come again next Wednesday. I will bring a piece of rope with me. If the tablets are still not here, I am going to hang myself from that tree.' He pointed to the window. I believed he meant what he said," the doctor wrote.

Fortunately, he was able to get a repeat prescription.

According to the report, 298.5 metric tonnes of morphine-equivalent opioids are distributed around the world per year, but only 0.1 metric tonne makes it to low-income countries.

The difference is shocking if you compare the availability of these drugs in Canada, a rich country, and Haiti, a poor country.

In Canada, the annual distribution of morphine is more than 68,000mg per patient in need of end-of-life care; while in Haiti, it is just five mg per patient, which means 99 per cent of the country's need is not met.

According to the authors, the discrepancy is simply not good enough.

"The fact that access to such an inexpensive, essential and effective intervention is denied to most patients in low-income and middle-income countries and in particular to poor people ... is a medical, public health and moral failing and a travesty of justice," the authors wrote.

They blame a number of factors.

First, most health policies focus on giving people longer and healthier lives, instead of alleviating pain and giving them more dignity at the end.

They argue "serious health-related suffering" should become a new target as a measure of need for care in global health.

Second, they say "opiphobia" - which is prejudice and misinformation about the appropriate medical use of opioids - is a big deal.

It's an issue a number of chronic pain sufferers have raised with news.com.au, explaining they are often made to feel like "second-hand citizen[s]" and "criminals" for seeking out opioids as a way to alleviate their symptoms.

However, considering more Australians are dying from accidental opioid overdoses each year - and two-thirds of them are from prescription painkillers - the global medical industry clearly has some tough questions to answer.

kirrily.schwarz@news.com.au

Topics:  drug use editors picks opiate addiction opiates



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