Indian patients deprived of opioid benefits, say experts

VARANASI: The government's negligence regarding simplification of the rules and regulations for procurement of opioids (opium's derivatives used as analgesic), for the palliative care of the patients suffering from diseases like cancer is an issue of concern, said professor Anil Agrawal of department of Anaesthesia, Sanjay Gandhi Post Graduate Institute (SGPGI) of Medical Sciences, Lucknow.
Prof Agrawal, a leading name in the field of palliative care, was in the city to participate in an event organised by the faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University on Friday.
He said, it is a very disappointing fact that despite being the largest producer of opium in the world, India has done very little to allow its people to take benefit of opium's various derivatives with analgesic qualities including morphine.
"If we analyse the scenario of morphine use across the world post 1986, the year when the WHO cleared the way for the use of morphine as an analgesic for cancer patients, there has been a continuous and gradual rise in its in the developed countries, whereas, in India it has been gradually decreasing. This means that 91% cancer patients of the 17% of the world's population living in developed countries have access to morphine and other opioids while out of 83% of the total world population living in underdeveloped or developing countries only 9% have access to these drugs," said Agrawal.
He further added that it was strange that Us and Europian countries import opoids from India to treat their patients but Indians are still deprived of its benefits. However, the Indian government has asked its states to take required steps in this direction, he said.
"In fact, Kerala is leading with almost 80% of the total palliative care activities of the country. Apart from Kerala, other states in southre part of the country have also shown progress in this direction but the northern sates like Uttar Pradesh and Bihar are still lagging far behind in ensuring less painful journey for the patients suffering from diseases like cancer," said Agrawal.
It is worth to mention here that a single tablet of morphine costs mere 70 paise as against Rs 300 for a single dose of the pain killer presently being used as a pain reliever in India. As per Prof Agrawal, apart from the stringent rules and regulations in India that discourage drug manufacturers and marketing agencies from trading medicines that involve opioids in their preparation, some false notions also discourage their use.
There are some false notions about the use of morphine use like they create respiratory troubles and cause an addiction. "Studies on cancer patients administered opioids have proved that none of these notion are true. In fact, for the cancer patients, palliative care is equally important as the treatment, because it reduces the intensity of pain and thereby enhances the quality of life during their treatment and chaemotherapy, which generally takes a long time," said Agrawal.
The professor said that a large number of cancer patients have to go through a severe and prolonged pain during the that sometimes they get mentally disoriented. The studies also indicate that the pain also affects the rate of mortality in such patients.
Meanwhile, on the academic front also the scene of palliative care is not very bright, said Prof Agrawal. Very few medical institutes provide training in palliative care to the medical professionals. In fact the Trivendrum Institute of Palliative Care is perhaps the only institute that offers a MD course in palliative care. "Now we have started an initiative wherein we will hold a two-day workshop on palliative care for the final year MBBS and BAMS students in medical colleges across the country," he said.