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At a time when most of the countries are hesitant to prescribe controlled medicines such as opioid analgesics for pain relief or morphine to treat moderate to severe pain, Kerala has taken a lead by making available such drugs in its number of community-based palliative care centres.
Appreciating Kerala’s move, the World Health Organsiation in its latest report has noted that the southern State, world leader in community participation in the provision of care to the terminally ill, is likely to become the first Government in the world to formally incorporate palliative care into primary healthcare.
Controlled medicines are listed under the international conventions on narcotic and psychotropic drugs and their precursors. However, only six developed countries reported the highest level of such controlled medicines such as morphine consumption while majority of developing nations reported low consumption.
“This implies that millions of patients with moderate to severe pain caused by different diseases and conditions are not getting treatment to alleviate their suffering,” said the recent WHO report, World Medicines Situation 2011: Access to Controlled Medicines.
Besides giving case study of Romainia and Uganada which are taking measures to provide controlled medicines, the report has also cited the example of Kerala in India.
"The state controlled substances regulations have been progressively simplified since the 1990s, and a new licensing system has increased the number of community-based palliative care centres with oral morphine, with little or any diversion or misuse."
This is in contrast with other Indian states, notes the report.
One reason for the low rate of use of opioid analgesics is the fear of both health providers and patients that the latter will become dependent on or will abuse these medicines.
"Not all states and territories in India have amended their state legislation and rules according to the revised central government legislation on opioids, and if they have done so, they omitted operationalizing policy changes and education for professionals, administrators and the public to ensure palliative care for their population," the report further said.
In Kerala, about 80 per cent of India's palliative care is reported to be delivered in the state. The WHO report has also taken note of the fact that in July 2009, the State Directorate of Health Services issued an order to integrate palliative care into the primary health-care system.
Appreciating Kerala’s move, the World Health Organsiation in its latest report has noted that the southern State, world leader in community participation in the provision of care to the terminally ill, is likely to become the first Government in the world to formally incorporate palliative care into primary healthcare.
Controlled medicines are listed under the international conventions on narcotic and psychotropic drugs and their precursors. However, only six developed countries reported the highest level of such controlled medicines such as morphine consumption while majority of developing nations reported low consumption.
“This implies that millions of patients with moderate to severe pain caused by different diseases and conditions are not getting treatment to alleviate their suffering,” said the recent WHO report, World Medicines Situation 2011: Access to Controlled Medicines.
Besides giving case study of Romainia and Uganada which are taking measures to provide controlled medicines, the report has also cited the example of Kerala in India.
"The state controlled substances regulations have been progressively simplified since the 1990s, and a new licensing system has increased the number of community-based palliative care centres with oral morphine, with little or any diversion or misuse."
This is in contrast with other Indian states, notes the report.
One reason for the low rate of use of opioid analgesics is the fear of both health providers and patients that the latter will become dependent on or will abuse these medicines.
"Not all states and territories in India have amended their state legislation and rules according to the revised central government legislation on opioids, and if they have done so, they omitted operationalizing policy changes and education for professionals, administrators and the public to ensure palliative care for their population," the report further said.
In Kerala, about 80 per cent of India's palliative care is reported to be delivered in the state. The WHO report has also taken note of the fact that in July 2009, the State Directorate of Health Services issued an order to integrate palliative care into the primary health-care system.
