Ensuring Opioid Availability: Methods and Resources
The pain and palliative care fields are encouraged to learn about government drug control policy and to engage with their governments to examine these policies and their implementation in order to address impediments to patient access to pain management. Although pain management is a necessary part of palliative care, it is often impossible because strict national and state regulations block access to opioid analgesics. It is important for us to know that in adhering to international drug treaties, governments often concentrate on drug control to the exclusion of their obligation to ensure opioid availability for medical and scientific purposes. Indeed, international health and regulatory authorities are increasingly concerned about wide disparities in national consumption of opioid analgesics and have called on governments to address barriers in their national laws and regulations that govern the prescribing of opioid analgesics. The Pain & Policy Studies Group (PPSG) has developed methods and resources to assist governments and pain and palliative care groups to examine national policies and make regulatory changes. Romania, India, and Italy are examples. The PPSG is developing several new resources, including a training program for Fellows from low- and middle-income countries, enhanced support of collaborators working on opioid availability, an internet course in international pain policy, an improved website with policy resources and country profiles, and new approaches to the study of opioid consumption indicators.
Established in 1996 at the University of Wisconsin Comprehensive Cancer Center (now the Paul P. Carbone Comprehensive Cancer Center in the University of Wisconsin School of Medicine and Public Health), the Pain & Policy Studies Group (PPSG) has been developing methods to evaluate and improve national policies that govern availability and access to the medicines that are essential for relieving severe pain throughout the world. The PPSG was recently redesignated as a World Health Organization (WHO) Collaborating Center (WHOCC) until 2010. This article summarizes policy evaluation methods and their application in several countries and describes additional resources PPSG is developing to support improved access to pain relief medicines. (This article addresses policy evaluation in countries other than the USA; for results of PPSG's evaluation of policy in the USA, please see http://www.painpolicy.wisc.edu/Achieving_Balance/i ndex.html.)