Research in the management of cancer pain has produced new knowledge about pain and how opioids act in the body. Traditionally, opioid analgesics have been used to manage acute pain. Long-term use of opioids has been discouraged because of the risk of tolerance or physical or psychological dependence. Studies have also shown that morphine and some other opioids can be safely administered in increasing amounts until the pain is relieved with no fear of an overdose.
Many countries have significant difficulties obtaining and distributing drugs for any type of illness. In these countries, the unavailability is often due to a combination of factors, such as inadequate funding of health services, lack of health care delivery, and inadequate facilities for the storage and distribution of medicines.
A country will obtain its supply of opioids by importing them from another country, manufacturing them itself, or both. They are then distributed by manufacturers or wholesalers to hospitals and pharmacies, and dispensed to patients by health care personnel. Diversion of narcotic drugs from the legal trade into illegal channels remains fairly rare and the quantities involved are relatively small.
Individual workers must be authorized to dispense opioids either by virtue of their professional license, or by a special license. The movement of opioids may occur only between duly authorized parties, and a medical prescription is required before opioids may be dispensed to a patient.
In some countries, fear of drug abuse has resulted in laws and regulations that make it unnecessarily difficult to obtain opioids for medical use. Just because opiate availability is restricted, that doesn’t mean that will stop the abuse of illegally procured drugs. In fact, such overly restrictive laws and regulations serve no purpose but to deprive people who really need opiates of access to the medications.
Health care workers may be reluctant to prescribe, stock, or dispense opioids if they feel that there is the possibility of their professional licenses being suspended or revoked if large quantities of opioids are given to an individual, even though the medical need for such drugs can be proved.
This serves to cause even more problems for patients with a true need for opioids to help control their pain.
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