Do National Drug Control Laws Ensure the Availability of Opioids for Medical and Scientific Purposes?
In a report to the United Nations, the International Narcotics Control Board (INCB) stated:
“One of the fundamental objectives of the international drug control treaties is to ensure the availability of narcotic drugs and psychotropic substances for medical and scientific purposes and to promote the rational use of narcotic drugs and psychotropic substances.”1
Countries that signed the 1961 Single Convention on Narcotic Drugs as Amended by the 1972 Protocol, hereafter referred to as the Single Convention, are expected to abide by the Convention’s provisions on the control of certain drugs while ensuring that these drugs are available for medical purposes. The Single Convention established a medicolegal principle of balance: governments have a dual obligation to prevent the diversion and abuse of narcotic drugs and to ensure adequate provision of opioid analgesics for legitimate medical and scientific purposes.2 In this paper, we use the word “balance” in the way it is used by international organizations, such as the United Nations Economic and Social Council, the INCB,3 the World Health Organization (WHO)2 and the Commission on Narcotic Drugs.4 Drug availability is ensured most effectively in the context of balance and drug control is achieved most effectively when carried out with availability in mind. Table 1 lists the principal measures proposed by the Single Convention to ensure the availability and control of Schedule I drugs in situations in which a closed drug control system has been established to give a government authority over other involved parties, thus preventing the diversion and nonmedical use of these substances. Schedule I drugs belong to one of four schedules of drugs classified by the Single Convention according to their potential for abuse and medical value. These drugs are recognized as being essential for medical and scientific purposes but, since they are also the most susceptible to abuse, are subject to the most stringent control of all medical drugs. Drugs may be added to Schedule I by the Commission on Narcotic Drugs on the recommendation of WHO if they have the same potential for abuse as other drugs on the schedule.5