Posted on 07/22/2011 12:16:50 AM PDT by Uncle Miltie
For many in the West pain ends with a pill, but elsewhere the war on drugs is cutting people off from pain medication.
For much of the Western world, physical pain ends with a simple pill. Yet more than half the world's countries have little to no access to morphine, the gold standard for treating medical pain.
Freedom from Pain shines a light on this under-reported story. "For a victim of police torture, they will usually sign a confession and the torture stops," says Diederik Lohman of Human Rights Watch in the film. "For someone who has cancer pain, that torturous experience continues for weeks, and sometimes months on end."
Unlike so many global health problems, pain treatment is not about money or a lack of drugs, since morphine costs pennies per dose and is easily made. The treatment of pain is complicated by many factors, including drug laws, bureaucratic rigidity and commercial disincentives.
In India, the first stop in the film and the world's largest grower of medicinal poppy for developed countries, there are severe restrictions to the use of morphine domestically. In 27 out of 28 states in India, narcotics laws are so strict that doctors fear prescribing it, and patients literally scream for relief. Drug companies have little incentive to manufacture morphine for the domestic market because of reporting requirements and small profit margins.
In the Ukraine, the film reveals that access to pain medication is halted by outdated, Soviet-style bureaucracy, arbitrary limits on doses, and a lack of oral morphine. As a result, many patients experience prolonged bouts of untreated pain, particularly in rural areas. In the Ukraine, we learn that Artur, a former decorated KGB colonel suffering from prostate cancer, sleeps with a gun under his pillow - his only way out, should he decide his pain is too great.
Nadia, a single mother living in Kiev, tells of the anguish of living with a son in constant pain. Vlad, her son, was diagnosed with terminal cancer and sent home from the hospital with nothing but the meagre government dose of pain killers. Nadia recounts how his agony grew to the point where he once attempted suicide, nearly throwing himself from a four story window. It would be another three long years of mother and son battling with severe pain until Vlad died.
Until the Ukrainian leadership acts to remove the barriers to palliative care, it falls to defiant individuals like Sergey Psiurnyk, a modern-day Robin Hood, to ensure that suffering people get the morphine they need. Riding with Psiurnyk as he makes his rounds, he says he risks years in jail to collect morphine from sick people who do not need it and deliver it to people who do.
Overall, Freedom from Pain reveals that bureaucratic hurdles, and the chilling effect of the global war on drugs, are the main impediments to a pain free world. Patients will continue to suffer until global bodies actively work with countries to exclude medical morphine from the war on drugs, and change the blunt drug laws that curtail access to legitimate medical opiates worldwide. Uri Fedotov, the executive director of the United Nations Office of Drugs and Crime, admits in the film that the war on drugs is cutting people off from pain medication, but offers little in the way of concrete proposals for changing the status quo.
Lohman points out that inertia may be the greatest obstacle to improving access to morphine, and that pressure brought by doctors and human rights activists is critical to getting pain medication to the people who need it. That is what happened in Uganda, the final stop in the film. Dr Jack Jagwe, who served in that war-torn country's health ministry in the 1990s, worked closely with foreign doctors and the international community to put into writing that every citizen there should have the right to palliative care - a first in Africa.
Uganda also changed its laws to allow nurses in rural areas to prescribe morphine - another first. Today, they visit people in pain and administer liquid morphine without any doctor's involvement. Uganda is seen as a potential model for pain treatment, but most improvements around the world have been small and localised, resulting from the efforts of "enterprising entrepreneurs" like Dr M. R. Rajagopal, a pioneer of palliative care. In India, medical morphine is readily accessible only in the small state of Kerala because of his unceasing efforts.
With the help of his colleagues and the cooperation of the state drug controller, Rajagopal led the push to create a streamlined operating procedure for morphine licensing in Kerala. Now patients in desperate need of pain drugs have access and doctors do not fear strict penalties. Rajagopal, who has helped create a model for the rest of India, says what is desperately needed is "systematic evaluation of the problem ... in the developing world, and an action plan aimed at overcoming it".
Freedom from Pain was shot and produced by a team of students and teachers from the University of British Columbia's Graduate School of Journalism International Reporting Program (IRP). Peter W. Klein, an award-winning producer who is the director of the UBC School of Journalism and the IRP, led the project.
I know for a fact we have problems in this country, all due to govt meddling. Drug addicts will always be with us, but there is n excuse for denying relief to those who suffer. My sinus meds, which do not make anyone high, are controlled now, and I can only buy less than the max monthly dose each month. Then there are the times I needed something, and couldn’t get something for pain, because of squeemish doctors. It will only get worse, IMO.
I get greatly tired of the always concern for anyone EXCEPT those that have real need in America. Lots and lots of people can’t afford food and drugs or the drugs that will save their lives, yet all humanity, or some dollywood conceited fool is always for some poor people anywhere else in the world.
Why they don’t have drugs is because they are ruled by dictators and communists. If they get rid of them, they will have a way to figure out how to get their drugs and everything else.
I get greatly tired of the always concern for anyone EXCEPT those that have real need in America. Lots and lots of people can’t afford food and drugs or the drugs that will save their lives, yet all humanity, or some dollywood conceited fool is always for some poor people anywhere else in the world.
Why they don’t have drugs is because they are ruled by dictators and communists. If they get rid of them, they will have a way to figure out how to get their drugs and everything else.
You realize that you badly contradicted yourself in your post?
Original Sudafed has to now be purchased at a pharmacy and signed for. You can’t get paregoric that way anymore. You can’t get terpin hydrate like that anymore. And I don’t know what else is so controlled now it’s ridiculous.
But junkies still get their dope and create new ones while normal people jump through government hoops.
Between the dim-witted restrictions on Sudafed, and the horror of no knock drug raids, I’ve gone from an opponent of recreational drugs to a “let’em snort anything they can get up their nose” advocate.
The simple fact is my life and property is under almost no threat from users and sellers of illegal drugs, while I am functionally defenseless against the caprice of any and every LEO that crosses my path.
The concept of chronic and intractable pain is beyond the imaginations, perhaps, of the hoards entranced by Pop Culture.
During Sam Ervin's Watergate hearings, ranking committee member Senator Ed Gurney (R-FL) was introduced to the national audience. Among the factoids delivered in the color commentary during that 1973 spectacle concerned Gurney's World War II Purple Heart, and that he suffered from chronic pain, and was, in fact, "in constant pain."
Barely 15 years of age, I remember being stunned by this information. The idea someone was in continuous pain was new information.
It was shocking to hear, and it shook me. Today, of course, with an arthritic condition of my own, it's not difficult to grasp at all. Sixty million Americans, to one degree or another, are being treated for chronic pain - and that's only the bona fide sample. And you don't even have to bring a complete end to the "War on (some) Drugs" to stem the diversion of prescribed medicine to addicts.
And for those who also happen to become debilitating addicts there's no longer any need for that condition to become a problem.
The DEA's policies, in regard to prescribed artificial and authentic opiates has made pharmacists into law enforcement agents and driven good doctors out of the marketplace.
The stigma of being treated for chronic and intractable pain has been largely transferred from friends and family to those in the medical profession who don't relish the idea of their licensing becoming targets for bureaucrats with badges.
There are addicts and their are patient, many of the latter having gone through a gauntlet of doctors and diagnostic in order to obtain treatment.
Chronic pain is isolating, among other things, by itself - the patient's ever-present topic of conversation. It ruins health and lives, and this isolation is preventing this large group of Americans from exercising their otherwise potentially high political clout.
Not the least of their problems is being tossed into the same bag as those unfortunates who really doctor shop or rob pharmacies, thereby becoming part of a larger public health and criminal law issue. As a result, the bona fide bunch are often under-treated or inadequately treated for their conditions.
Some way needs to found to instantly separate those with the paper and X-ray trail, in many case proving their bona fides, from the pitiful junkie.
In the latter case, there is now a cure for opiate withdrawal building a much better case for its effectiveness than methadone. Buphamorphine-Naloxone compounds, marketed as Suboxone, is a powerful tool that works for the willing.
(Off my Soapbox.)
My son-in-law is a registered nurse. He has first-hand experience with how the drug companies and doctors work together to push new medications (even inventing new “disorders” to target with the meds) and how they will push the newest, most expensive, less-tested stuff because of kickbacks and even refuse to write to allow generics. He also says that they tend to over prescribe pain meds for out-patients while under medicating for many severe pain cases that are hospitalized.
I found both your replies very interesting. I have a ruptured disk and I have migraines. I am very familiar with pain.
My wife had chronic pain for about a decade. Her pain level was either 8, 9 or 10 on a scale of 10 for the whole decade.
She had to be totally hopped up on opiates so she wasn’t in screaming howling pain.
Eventually we were referred to the Mayo Clinic Pain center in MN. She went there for a month, and they threw about 60 different treatments / techniques / exercises, etc. at her, dried her out off the opiates, and taught her how to live with the pain.
She now has a pain level of about 3 all day, every day, and is off the drugs.
Nobody ever diagnosed what was wrong with her. They don’t know, we don’t know, and they can’t cure it.
But at least we have pain management under control. We’re back to being relatively normal people after about a decade of living hell.
I sincerely hope that the legislators, bureaucrats, cops, prosecutors, etc who make it difficult, dangerous, expensive or impossible for pain sufferers to get the palliative drugs that they need, will die screaming and burn in hell.
I am done giving those who support the war on drugs any benefit of the doubt. They are not confused, misinformed or in error. They are evil.
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