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.
ATOME’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.