RESOURCES FOR OPIOID AVAILABILITY

This page provides information on printed and web-based resources to improve opioid availability.



World Health Organization. Achieving balance in national opioids control policy, Geneva: 2000.
This is WHO's most recent publication on opioid availability. This document provides 16 guidelines that can be used by governments and health professionals to assess the national narcotic control policies of any country to determine if they contain the provisions, procedures and cooperation that are necessary to ensure the availability of opioid analgesics that are essential for the relief of pain. The guidelines are derived from the international principle of "balance" in drug control policy. This principle which is carefully and extensively documented, asserts that governments not only have an obligation to prevent drug abuse, but also to ensure the availability of opioid analgesics for medical purposes. The document asserts that efforts to prevent drug abuse and diversion must not interfere with the adequate availability of opioid analgesics for patients' pain relief. The importance of cooperation between regulators and health professionals is emphasized.

Contact: To order print copies in English, contact Mrs. Caroline Mullen, Department of Essential Drugs and Medicines Policy, World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland. Tel.: 41-22-791-2337; Fax: 41-22-791-4761;
Email: mullenc@who.ch

The English edition is available online at: http://www.painpolicy.wisc.edu/publicat/00whoabi/00whoabi.htm

The Spanish edition, entitled Guia para el analisis de las politicas nacionales para asegurar la disponibilidad de opioides y la provision de cuidados paliativos: Guias para autoevaluaciĆ³n, as well as the French and Italian editions are in preparation.

World Health Organization. Cancer Pain Relief With a guide to opioid availability. Geneva:1996.
Part one reviews the simple and practical WHO analgesic method to relieve the pain syndromes in cancer.
Part two describes the international system by which morphine and other opioids are regulated and made available for medical purposes. It concludes with the principles that should be used to regulate the dispensing of opioids by physicians, nurses and pharmacists.
Contact: To order print copies in English, French and Spanish [order #1152247, US$15.30], contact WHO Distribution and Sales, 1211 Geneva 27, Switzerland.
Tel.: 41-22-791-2476
Fax: 41-22-791-4857
Email: bookorders@who.ch

Part 2 of the English edition is available online at: http://www.medsch.wisc.edu/painpolicy/publicat/cprguid.htm

Other language editions are available in Bengali, Chinese, Dutch, German, Greek, Indonesian, Italian, Japanese, Korean, Portuguese, Russian, Serbian and Vietnamese from publishers in most countries. A list of WHO sales agents is available on the internet at: http://www.who.int/bookorders/.

International Narcotics Control Board. Availability of opiates for medical needs. New York: United Nations, 1996.
This report, based on a survey of governments in the world, provides data showing that opioids are widely unavailable for medical needs. INCB recommends steps that governments and health professionals should take to address this problem.

Contact: To order print copies in English, Spanish or French, write to UN Publications, Sales and Office Bookshop, CH-1211 Geneva 10, Switzerland.
Tel.: 41-22-917-2614
Fax: 41-22-917-0027
Email: unpubli@unog.ch
Also available online in PDF format at: http://www.incb.org

Pain & Policy Studies Group Website:

The goal of the Pain & Policy Studies Group/WHO Collaborating Center is to improve the availability and use of opioid analgesics, especially morphine and other strong opioids, for the treatment of pain due to cancer, according to the recommendations of the World Health Organization, and consistent with international drug control treaties. The PPSG website [http://www.painpolicy.wisc.edu/] provides a resource guide, articles about pain policy, and information on trends in opioid consumption for individual countries. The following monographs are especially relevant for anyone looking for information on morphine and/or pethidine consumption:

LATIN AMERICA

  • Opioid analgesic for cancer pain relief: A review of consumption trends and the literature. U. of Wisconsin:1994 (Monograph).
    Available online in full text at: www.medsch.wisc.edu/painpolicy/publicat/monograp/latin.htm
  • Disponibilidad de opioides para el alivio del dolor en cancer: Puntos relevantes en America Latina. U. of Wisconsin: 1999 (Monografia). Available in print by request from: ppsg@med.wisc.edu
  • Consumo de analgesicos opioides en el mundo y la region andina. U. of Wisconsin: 2000 (Monografia) Available in print by request from: ppsg@med.wisc.edu
    These monographs review opioid analgesic consumption trends with a special focus on Latin America. Discussion of how to improve availability of opioid analgesics while preventing diversion and abuse.

ASIA.
Opioid analgesic for cancer pain relief: A review of consumption trends and the literature relating to Asian countries. U. of  Wisconsin:1994 (Monograph).
This monograph reviews opioid analgesic consumption trends with a special focus on Asia. Discusses how to improve availability of opioid analgesics while preventing diversion and abuse. Available online in full text at: www.medsch.wisc.edu/painpolicy/publicat/monograp/asia.htm

EUROPE.
Opioid availability: Diagnosis and treatment of regulatory barriers. U. of Wisconsin:1997 (Monograph).
This monograph reviews opioid analgesic consumption trends with a special focus on Europe. Includes references to key articles and reports.
Available online in full text at: www.medsch.wisc.edu/painpolicy/publicat/monograp/cyprus.htm

GENERAL.
To what extent has the WHO Analgesic Ladder influenced morphine consumption in the world? U. of Wisconsin: 1997 (Monograph).
Available online in full text at: www.medsch.wisc.edu/painpolicy/publicat/monograp/germany.htm




REFERENCES

[Starting with the most recent publication and within the last 5 years]

Joranson DE, Ryan KM, Gilson AM, Dahl JL. Trends in medical use and abuse of opioid analgesics. JAMA 2000; 283: 1710-1714.
Available online in full text here

Carles de Marques B, Toro R. Making opioids available: Communication with government and nongovernmental organizations prevents opioid shortages. Cancer Pain Release 1999; 12 (2): 3.
Available online in full text here

Cepeda S. Making opioids available: Hospital pharmacy makes less expensive tablets. Cancer Pain Release 1999; 12 (2) 3.
Available online in full text here

Bertolino, Wenk, Ochoa, Pussetto. Making opioids available. Magistral preparations bring opioid costs down. Cancer Pain Release 1999; 12 (2): 3.
Available online in full text here

Sala R. Making opioids available: The benefit of sharing information about opioid requirements. Cancer Pain Release 1999; 12 (2): p. 2.
Available online in full text here

WHO Regional Office for the Americas endorses equity of access to palliative care. In: Cancer Pain Release (Colleau SM, ed.) 1999; 12 (2) pp. 1-2.
Available online in full text here:

Selva C. International control of opioids for medical use. European Journal of Palliative Care, 1997; 4 (6): 194-198.
Available online in full text here

De Lima L, Bruera E, Joranson D. Opioid availability in Latin America: The Santo Domingo Report. Progress since the Declaration of Florianopolis. J Pain Symptom Manage 1997; 13: 213-219.

Colleau SM, Joranson DE. Medical needs for opioids far from being met. Cancer Pain Release, 1996, Vol. 9, Supplement.
Available online in full text here

Joranson SM, Colleau SM. Highlights of the INCB report. Cancer Pain Release, 1996, Vol. 9, Supplement.
Available online in full text here