“” “balance” jim cleary, md associate professor of medicine director, palliative care...
TRANSCRIPT
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“Balance”
Jim Cleary, MDAssociate Professor of Medicine
Director, Palliative Care Medicine, UW Hospital & Clinics
Director, WHO Collaborating Center for Pain Policy and Palliative Care
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Establishes a Framework to:
1.Prevent abuse and diversion, and
2.Ensure the availability of drugs for medical purposes
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“Balance”
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“the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering… adequate provision must be made to ensure the availability of narcotic drugs for such purposes.” (Preamble, p. 13)
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“The low levels of consumption of opioid analgesics for the treatment of pain in many countries, in particular in developing countries, continue to be a matter of serious concern to the Board.
The Board again urges all Governments concerned to…take steps to improve the availability of those narcotic drugs for medical purposes…”
(INCB 2007 Annual Report, p. 20)
INCB Concern
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Why is opioid use so low?
1995 Survey of government drug control authorities – 65 countries
Impediments to opioid availability:
Fear of addiction
Lack of training
Excessively restrictive laws and regulations
Fear of legal consequences
Insufficient amount of opioids
Cost of opioids
Inadequate health care resources
Lack of national policy, guidelinesInternational Narcotics Control Board. (1996). Report of the International Narcotics Control Board for 1995: Availability of Opiates for Medical Needs. New York, NY: United Nations.
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Why is opioid use so low?
2006 Survey of Health care workers, and hospice/PC staff in Asia, Africa and Latin America
Adams, V. (2007). Access to Pain Relief – an essential human right. Help the Hospices, Worldwide Palliative Care Alliance.
Barriers to accessing oral morphine: Excessively strict national drug laws and regulations; Fear of addiction;Poorly developed health care systems;Lack of knowledge
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Barriers
1) Opioid Regulatory Policy
2) Drug Distribution System
3) Cost of Opioid Analgesics
4) Knowledge & Attitudes
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For governments and health professionals
Explains need, rationale and imperative
16 criteria
Simplified Checklist
22 Languages
Achieving Balance in National Opioids Control Policy: Guidelines for Assessment (2000)
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“Balance” is the Fundamental Principle
National policy should establish a drug control system that prevents diversion and ensures adequate availability for medical use
Drug control measures should not interfere with medical access to opioid
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Документ № WHO/EDM/QSM/2000.4СТАТУС ДОКУМЕНТА: ЗАГАЛЬНИЙ
WORLD HEALTH ORGANIZATIONВСЕСВІТНЯ ОРГАНІЗАЦІЯ ОХОРОНИ ЗДОРОВ’Я
НАРКОТИЧНІ ТА ПСИХОТРОПНІ ПРЕПАРАТИ
ДОСЯГНЕННЯ ВІДПОВІДНОСТІНАЦІОНАЛЬНИХ ПОЛІТИК
КОНТРОЛЮ ЗА ЗАСТОСУВАННЯМ ОПІОЇДІВ
РЕКОМЕНДАЦІЇ ЩОДО ОЦІНЮВАННЯ
WORLD HEALTH ORGANIZATION
ВСЕСВІТНЯ ОРГАНІЗАЦІЯ ОХОРОНИ ЗДОРОВ’Я
Arabic
Bulgarian
Chinese
English
French
German
Hindi
Indonesian
Italian
Lithuanian
Mongolian
www.painpolicy.wisc.edu
Polish
Portuguese
Romanian
Russian
Serbian
Spanish
Swahili
Tagalog
Turkish
Ukrainian
Vietnamese
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WHO Public Health Model__________________________
DrugAvailability
Education
Policy
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Consumption of Morphine 1980 - 2003 East vs. West Europe (mg/capita/yr)
mg/capita
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Joranson,
Lancet 2006
World Health Organization Collaborating Centerfor Pain
Policy and Palliative Care
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