Access to Opioids in Europe Called ‘Human Right’

Access to Opioids in Europe Called ‘Human Right’

At a time when chronic pain patients in the U.S. are increasingly being denied access to opioids, efforts are underway in 12 countries in Eastern Europe to increase access to opioids and eliminate the stigma associated with them.

A five-year study by Access to Opioid Medication in Europe (ATOME) looked at why opioid pain medicines – such as morphine and codeine – are not widely available or virtually non-existent in a dozen countries stretching from Poland to Turkey.

bigstock-Older-man-shaking-out-pills-in-120526461-199x300ATOME’s final report says access to opioids should be “considered a human right.”

“Opioid medicines are the mainstay of medical treatment of severe pain and breathlessness, and the treatment of opioid dependence. They are effective and cheap medicines to relieve unbearable suffering from physical symptoms in severe progressive illness,” the report states.

“In the twelve European countries addressed by this project, strict regulations and inappropriate policies were found to have negative impact on adequate access to opioid medicines. Major barriers were found to exist in these countries in the field of legislation; national policies; knowledge and societal attitudes; and economic aspects, including affordability.”

Steps have already begun in all 12 countries, according to the report, to change policies and legislation that limit access to opioids. One of the simpler steps was to stop using stigmatizing words about opioids – such as calling them “narcotic drugs” – in legal documents.

“There is a stigma of drugs on the streets which is why social attitudes are a big barrier in many of these countries. Opioids are treated as narcotics and very strictly controlled because there is a fear that opioids will cause addiction,” said Professor Sheila Payne from the International Observatory on End of Life Care at Lancaster University in England, one of the authors of the report.

“But if they are used at the end of life or if people are in great pain, addiction is not a problem. In some countries, you can only get opioids if you are in hospital, which is no good if you wish to die at home.”

Other steps recommended by the ATOME project:

  • Adopt policies of the World Health Organization (WHO), which defines opioids as “essential medicines” for the treatment of severe pain.
  • Identify potential legal and regulatory barriers to opioids, with the goal of improving their availability and affordability.
  • Establish communication networks between regulatory agencies, healthcare professionals and patients to raise awareness about the impact of opioid policy decisions.
  • Ensure that treatment with opioids is included in undergraduate and postgraduate education for doctors, nurses and pharmacists.
  • Raise awareness in the general public about opioids through media campaigns and brochures for patients and their relatives.

“People hopefully will now have more access to accessible, affordable and available opioid medicines and our report provides a template which can be used not only in Europe but in other parts of the world,” said Payne.

Authored by: Pat Anson, Editor

There are 20 comments for this article
  1. Mark Ibsen at 6:44 am

    WE are the human rights violators we should be examining!

  2. Rhonda at 9:07 am

    i take norco they have now moved it up to a class II drug and harder to get and doesn;t do a whole lot for the pain i am in with fibro. back pain, oa, bursitits and have been fighting this pain a lonnnnggg time! About ready to read up on the law in OR yes it is that bad! i mean why not i have no quality of life used to love living life now i do good to get out of bed and get a shower and cook an occasional meal. Thanks DEA and docs

  3. BL at 5:03 pm

    rk, there are no laws that state a patient has to be on extended release meds and/or immediate release meds. Extended release are recommended for chronic pain. But that is not the same as a law. Your dr lied to you. Some drs no longer will prescribe extended release meds and immediate meds, commonly referred to as breakthrough meds.

  4. rk at 5:12 pm

    Whatever was written first made it sound like us patients on a long acting and ir med will be consideree an abuser. Well my old dr told me 2 years ago that the LAW required me to be on BOTH i never wanted to take the er med as it made ajd makes me too tired to funCTION BUT i was forced to. And yeadlh w so many Pharmacies refusing to fill prescriptions we CANT go TO just one and these ppl should bE WELL aware of all this as its been happening for years now.

  5. BL at 11:08 am

    rk, it isn’t saying that. It is targeted towards high doses of meds, combination of meds and the diagnosis. It has been recommended that Congress be asked to make changes so that Medicare can also require receipents to use only one pharmacy for all of their meds and only see one dr when overutilization is suspected. This would be like the Lock In program for Medicaid receipents who are suspected of drug abuse.

  6. rk at 7:47 pm

    They are not going to just cut off millions of pain patients sorry i wont believe that til i see it.

  7. BL at 1:08 pm

    rk, yes they can do it. You can’t escape this by changing to an Advantage plan, they’ve already thought about that.

  8. rk at 12:29 pm

    So does this mean if we are using part d that we need to switch to an advantage plan and get the part c instead?idont see how what you say can happen if people are not doing anything wrong. They cant do that w everything the pharmacists r doing to pain patients and refusing to fill their rx.

  9. BL at 11:04 am

    Coonhound, you’re correct, they definately do. Although Medicaid has been at it longer, Medicare will be catching up. The defination for when a receipent is overutilizing pain meds is left up the the individual Part D person(s) that is assigned to do this. Medicare itself doesn’t define it nor do the individual plans.

    Medicare Part D Overutilization Monitoring System-
    http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/HPMSmemo_MedicarePartDOverutilizationMonitoringSystem011714.pdf

  10. Coonhound at 10:42 pm

    BL-
    Hate to break it to you but Medicare has its sights set on an opioid crackdown as well.
    If one receives an ER and an IR pain med Rx then you are marked down as an abuser as you have more than 23 Rx per year (must have just picked that # arbitrarily) one less than most LEGIT PM clinics provide to their patients. If you have used 3 or more pharmacies in 2014 (pharmacy crawling=pharmacy SHOPPING).If you meet these criteria you are most part of
    ANOTHER DATABASE- *information below is taken from actual transcript records:

    *Another new development is CMS’s implementation of a centralized data system to track potential opioid overuse cases. This is called the Overutilization Monitoring System.

    http://www.hematology.org/Advocacy/PolicyNews/2014/3300.aspx
    transcript of actual meeting (PG 122) http://www.medpac.gov/documents/october-2014-meeting-transcript.pdf?sfvrsn=0

    Some shocking information that would have been nice to know before agreement w/ PM doc for my 2 surgeons to write for post op meds. Also ok’d by doctor was cough syrup due to complications of bronchitis/asthma/Interstitial Lung Disease hacking cough gave me a hernia so Tussionex it was. Everything above board, even using diff pharmacies as long as I kept him in the loop as they know it is hard to fill Scheduled meds in FL or GA.. Play by the rules, even Medicare Part D says you can use ANY pharmacy in your plan for any medication on the forumulary, whiz in the cup, bring in the med bottles, REQUEST other modalities, never missed appt, lost rx or any other BS red flag, yet according to this report I am an ABUSER. Anyone who has Medicare Part D, please do yourself a favor and read this information in the links here.

  11. Coonhound at 9:33 pm

    Trudy says “I guess that Europe and those other countries don’t have a DEA that needs to be funded”

    Trudy-I hate to tell you this but yes, they do have a DEA, OUR DEA. The US has 13 operation centers located in Europe, Poor fellas must have slept through geography class though as they don’t count Greece, Romania, or Bulgaria so officially its ‘only’ 10.

    I guess you are half right though, those countries don’t need to fund them, that’s what the American taxpayer is for. Financier for international policing. And it doesn’t end there. A whopping total of 67 countries ‘enjoy the opportunity’ to work side by side w/ our DEA agents.

    My guess is that if the DEA isn’t there to ‘help’ maybe more countries would be inclined to throw in the towel on the drug war. So far Portugal, The Netherlands, and Switzerland have said enough is enough. They focus on drug use as a medical and societal problem as opposed to a criminal one, Their results might just prove that the DEA is unnecessary. That it is a bloated Dinosaur, a totally useless, bureaucratic institution that relies on dogma, propaganda, and intimidation totally at odds with logical reasoning and critical thinking. That their ‘mission’ only empowers criminals and terrorists, and victimizes sick people.
    Oh wait they already did?

    Still I can’t help but wonder what the $50 Billion dollars we spend on the drug war might do to help folks like RJ, myself, and thousands of others who live somewhere just north or south of the Federal Poverty line. I guess with budget deficits being what they are and all they just have to prioritize. After all we are just statistics.
    http://www.dea.gov/divisions/international/europe.shtml

    Homework question of the day: How many countries have drug endorsement agencies with operation centers located within the United States?

  12. rk at 2:08 pm

    From what ivread, zohydro isnt carried at many phamacies and living in middle of nowhere im sure this pharmacy doesnt have it and i cant wait for it to be ordered because of taking almost all my meds before my dr appt due to them not working. I am afraid i would be put into withdrawals,and i cant risk losing my job,plus heard its very expensive n not sure my medicare would even cover it.so no i havent asked him im scared to mention anything anymore,ive also read that it doesnt work

  13. BL at 10:46 am

    rk, have you asked your dr about taking Zohydro ? It is time release hydrocodone. The difference in Zohydro and what you’re taking now is that Zohydro doesn’t contain acetaminphen and you only take it twice a day instead of every 4 hrs. Also since hydrocodone doesn’t make you sleep, that shouldn’t be a problem. There would be no need for the MS Contin with Zohydro.

    There are many drs who won’t give meds for breakthough pain.

  14. rk at 2:12 pm

    I only have mediCARE, he keeps saying 50 mg of hydrocodone a day is alot but it doesnt help me anymore ive been on this same dose for years and just moved to where the weather is freezing making pain even worse.i am afraid to switch drs because of all this bs happening.i also take 15 mg ms contin er which i can only take at night because it puts me to sleep cant function on it told him that several times too all the long acting drugs put me to sleep and i am forced to work part time.

  15. BL at 7:17 pm

    rk, if you have Medicare, you need to change drs. If you have Medicaid, there really isn’t much you can do. Medicaid Providers who are high prescribers of pain meds and certain other meds risk being disciplined by their states. I have put a link below that explains more about this. The state I’m in won’t cover Pain Management for their Medicaid Receipents, so things could be worse.

    Grassley Probes High-Volume Medicaid Prescribers-
    http://www.medpagetoday.com/ PublicHealthPolicy/Medicaid/ 30857?utm_medium=email& utm_campaign=DailyHeadlines& utm_source=

  16. Kaylee at 5:55 pm

    Humans had been using drugs derived from the opium poppy for thousands of years with out stigma or regulation. It’s only recently that it’s been more or less forbidden. It’s the same for cannabis. I think it’s ridiculous how we’re barred from using these substances that are obviously here on this planet for the very purpous of relieving pain.

  17. Trudy at 6:14 am

    I guess that Europe and those other countries don’t have a DEA that needs to be funded.

  18. rk at 6:34 am

    Wow i wish i could move here. I just started a part time job and i am suffering to the extreme , im on disability and shouldn’t be working but i am forced to due to having no help,and this is unbearable especy since im being undermedicated,my dr doesnt care that the low dose of opiods ive been,on for years is no longer touching my pain even when i wasnt working, now this is just too much and i am beginning to think about ending this for good,i honestly cant take it anymore.i now wont be able to go shopping or clean at all and have nobody to help me w anything. I wish i could move to top is country somehow and get adequate care.

  19. mark maginn at 10:21 pm

    I’ve said this before. It is a human right to have access to those medicines and treatments that combat the hellish pain people live with. If these medicines are with held by any means condemns a person with pain to torture, torture that may well cease when the patient is prescribed an opioid treatment. While these drugs may not be the ideal treatment they are now what’s available and brings some relief to millions.