Corporate health solution to government human-rights abuse

National wars on narcotics abuse are having unintended health consequences, according to new research. And they may amount to human rights violations. Fortunately, a potential solution only costs a fraction of a penny per pill.

New concerns are being voiced about government policies towards prescription opiod-based pain medicines that are leaving thousands of patients to suffer unnecessarily. Eastern European and central Asian countries including Lithuania, Tajikistan, Belarus, Albania, Georgia and the Ukraine have placed such stringent controls on pain meds that it is effectively denying medically necessary, and ethically required treatment to patients suffering from cancer and other conditions. While the WHO and International Narcotics Control Board assert that opioids be readily available and accessible for use when medically necessary, governments are countering that these steps are a necessary part of their wars on drugs.

Policies being used to limit access to pain relief include: requiring special patient permits, limiting prescriber's right to dispense the drugs, arbitrary limits on the strength or duration of pain relief meds, and erecting other bureaucratic roadblocks.

"This is an issue of cancer patients' human rights," says Dr. Nathan Cherny, one of the study authors from the Shaare Zedek Medical Center in Jerusalem, Israel. "Its not only a legal imperative, but a moral imperative for the WHO and individual European countries to address [it]."

Pain-control remains a problem in nations without such stringent controls as well. While approximately 80% of pharmacy visits in the US are for pain, only half of patients suffering from severe chronic pain receive adequate relief. In some cases this is due to the illusive nature of their condition, or intolerable drug side effects. But in a many cases it's attributable to clinicians inadequately trained in pain management, and in some cases a fear of over-prescribing powerful pain meds prone to abuse.

The solutions? Broadly speaking, better trained clinicians and policies that take pain seriously as a health problem. While abuse of prescription pain meds is growing, there's another relatively inexpensive and easy solution that drug manufacturers could provide (either voluntarily or by government mandate).  Since abusers generally crush pain pills before injecting them, coating individual tablets in narcotic-receptor blockers has been found to successfully reduce the abuse. Taken orally, the stomach removes and digests the narcotic-receptor blocker before moving on to the medicine. But crushing a coated tablet mixes the blocker into the mash, resulting in no "high." Purdue Pharma, manufacturer of Oxycontin, knows about this. In the US market their product is not coated, and is a widely abused street drug (some estimate that up to 10% of the company's profits come from such unintended and illegal use). After Western European regulators mandated coated tablets, abuse of Oxycontin practically vanished from that market. Render drugs un-abusable, and government limitations to access aren't necessary.

It's not often that businesses could potentially end human-rights abuse at such low cost. And the reminder that government and industry can work together to promote the public's health would be refreshing.

Photo credit: The author