Problematic access to opioid medicines for pain and treatment of dependence Willem Scholten, PharmD, MPA Consultant – Medicines and Controlled Substances Lopik, the Netherlands Former Team Leader, Access to Controlled Medicines, World Health Organization IAHPC Side-event Access to Opioid Medicines in Europe and the World Geneva, 19 May 2014
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Problematic access to opioid medicines for pain and treatment of dependence
Problematic access to opioid medicines for pain and treatment of dependence
Willem Scholten, PharmD, MPAConsultant – Medicines and Controlled SubstancesLopik, the Netherlands
Former Team Leader, Access to Controlled
Medicines, World Health Organization
IAHPC Side-event Access to Opioid Medicines in Europe and the WorldGeneva, 19 May 2014
The global treatment crisisThe global treatment crisis
3 | IAHPC Side-event on ATOME | Geneva 19 May 2014
Inequality Inequality
93.8% of all (licit) morphine consumption by 21.8% of the world population (INCB 2010, Data for 2009)
In 2006, 4.7 billion people live in countries where medical opioid consumption is near to zero (on a total world population of 6.5 billion) (Seya et al., JPPCP, 2011.)
In 2010, 4.65 billion people live in countries where medical opioid consumption is near to zero (on a total world population of 7 billion) (Scholten W and Duthey B, J Pain and Symptom Management, 2014; 47(2):283-297)
4 | IAHPC Side-event on ATOME | Geneva 19 May 2014
From: Scholten W and Duthey B; JPS 2014.
5 | IAHPC Side-event on ATOME | Geneva 19 May 2014
From: Scholten W and Duthey B; JPS 2014
6 | IAHPC Side-event on ATOME | Geneva 19 May 2014
Barriers for access to treatmentBarriers for access to treatment
Overly restrictive laws and regulations– Rules often not preventing abuse, dependence and diversion– Rules often creating a barrier for medical access
Insufficient medical education on pain
Attitudes – Excessive fear for dependence– Excessive fear for diversion– Problems related to assessment of medical needs
Economic– However, opioid analgesics are not expensive (on the international market)
Tools for improving access to controlled medicines
Tools for improving access to controlled medicines
8 | IAHPC Side-event on ATOME | Geneva 19 May 2014
WHO Policy GuidelinesWHO Policy Guidelines
15 languages In print: English, French and Spanish
On-line: free of charge (including languages of most ATOME countries)