The World Health Organisation has revealed huge discrepancies in the distribution of morphine around the world in a recent report, calling the issue a medical and moral emergency.
Morphine has long been a front-line treatment for pain, easing end-of-life transitions in palliative care and helping people undergoing medical emergencies, surgeries and chronic conditions.
But the drug is being unequally distributed around the globe, the WHO said in the report, detailing deep disparities in who can access the vital, opium-derived medication, The Washington Post reports.
“Millions of people continue to suffer preventable pain,” the experts wrote. The document is a report card on the worldwide use and availability of morphine, which is one of the oldest and least expensive opioids, but nonetheless is used more in higher-income countries such as the US, which used nearly 80% of the supply for the Americas region.
In contrast, lower-income countries face severe shortages because of irregular supply, local policies, lack of providers and stigma. Despite having similar medical needs, high-income countries consumed an estimated 125.9 doses per million people per day in 2021, compared with only two doses per million people per day in low-income countries.
To even out availability, the authors recommend establishing affordable pricing policies worldwide, creating distribution hubs and expanding access for people with conditions other than cancer and HIV.
Countries must also contend with the potential harms of morphine use, including substance misuse and illicit trade. Tight opioid regulations worldwide can make it hard to obtain the drug in medical settings, and negative attitudes persist among healthcare workers who fear prescribing morphine will cause long-term dependence in patients.
The authors cite one literature review that estimated 4.7% of those who use opioids to manage pain will go on to develop a future use disorder. But that’s not a reason to let people suffer rather than prescribe a safe, inexpensive and well-known pain medication, they conclude.
“Leaving people in pain when effective medicines are available for pain management, especially in the context of end-of-life care, should be a cause of serious concern for policy-makers,” said Yukiko Nakatani, WHO assistant director general for medicines and health products.
Morphine report
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