Reform of Drug Control Policy for Palliative Care in Romania
Unrelieved pain from cancer and HIV/AIDS is a substantial worldwide public‐health problem. Inadequate pain relief is partly due to excessively strict national drug‐control policies that constrain medical use of essential medicines such as morphine. Romania’s drug‐control policies are more than 35 years old and impose an antiquated regulatory system that is based on inpatient post‐surgical management of acute pain that restricts prescription authority and makes access to opioid treatment difficult for outpatients with severe chronic pain due to cancer or HIV/AIDS. A Ministry of Health palliative‐care commission used WHO guidelines to assess and recommend changes to Romania’s national drug control law and regulations. The Romanian parliament has adopted a new law that will simplify prescribing requirements and allow modern pain management Achievement of adequate pain relief is a vital part of worldwide health and will be dependent on reform of anti‐drug regulations in many countries.
According to WHO, there are about 22 million people with cancer in the world. Every year, around 10 million individuals are diagnosed with cancer and more than 6 million die from the disease. Tragically, these numbers are expected to double by 2020. More than 50% of new cases and deaths from cancer occur in developing countries.1 In central and eastern Europe, cancer mortality continues to rise despite an overall fall in cancer mortality for the entire region since the early 1990s.2 In Romania, with a population of 22 million, cancer is estimated to be the second leading cause of death.3,4 In 2002, it was estimated that there were over 41,000 deaths and almost 60,000 new cases of cancer in Romania.5 In men, lung, stomach, and colorectal cancers caused most deaths, whereas lung, colorectal, and prostate cancers accounted for most new cases. In women, breast, cervical, and colorectal cancers accounted for most deaths and most new cases.5 In Romania, more than two‐thirds of cancer patients are diagnosed at the late incurable stage of cancer.3