Balance, Pain, Palliative Care

“Back to School!” 3rd side of the triangle. LIFE before Death Film #12

Education is one of the three factors essential for a public health approach to improving access to opioids.  “Without education, it doesn’t matter how much morphine you have in the country, it won’t get to the patients.” Joan Marston

Serendipity came to play this morning with my WHO colleague, William Scholten, sharing this news from today’s Lancet, an interview with the Dr Volkow, the Director of the USA’s National Institute for Drug Abuse.  The story really does address the different sides of the “triangle.”

“The World Health Organization oversees the production of psychotherapeutics for a given nation so you have to justify how much drugs you need in a country and the United States has by far enormously higher quotas than other countries. Is it because we treat pain better? I don’t know that that’s the answer”, said Volkow.

“I think it poses the question, why do we have much greater need of opioid analgesics than other countries, and it’s tricky because you don’t want patients not to be able to get access to their medications because there’s not sufficient quantities but at the same time, the greater the amount of drugs out there available, the greater the likelihood that they are being diverted, the greater the likelihood that people become addicted or overdosed.”

And the story continues regarding more on education

Volkow is a leading proponent of the training of physicians on responsible prescription practices for the more than 1 million doctors authorised to prescribe certain controlled substances. Such training was proposed by Gil Kerlikowske, President Barack Obama’s national drugs policy director, and it would need congressional approval but it has been opposed by some state medical boards, which say mandatory classes would take time away from continuing medical education in the physician’s chosen specialty.

As Kathy Foley quoted from the IOM in the film, physicians are very much the biggest barrier. We need to get ourselves educated on the responsible prescribing of opioids for pain control!

Life before Death:

About Pain policy & palliative care

Improving global pain relief by achieving balanced access to opioids worldwide


5 thoughts on ““Back to School!” 3rd side of the triangle. LIFE before Death Film #12

  1. Great movie!
    Love the part where Dr Bunge from Argentina is saying that morphine was presented almost as a monster!
    It is so true.
    We can learn a lot from these short movies!

    Posted by Snezana Bosnjak | August 5, 2011, 12:49 PM
  2. Thanks for bringing this important issue to the sportlight, education is indeed a vital ingredient in palliative care development!

    Posted by Eva Duarte | August 5, 2011, 9:14 PM
  3. Thank you for quoting Dr. Nora Volkow. Her point here… that the higher consumption of opioids in the United States should not be considered an indication that we’re doing a better job of treating pain is very important. As is her point that greater access to opioids results in greater “likelihood that they are being diverted” and greater “likelihood that people become addicted or overdosed.”

    Her remarks are an excellent example of a balanced view because she acknowledges the harm caused by too much access in addition to the harm caused by inappropriate restrictions.

    In contrast, this video and the entire “life before death” series strike me as unbalanced because the videos fail to acknowledge that some restrictions on access are appropriate and that opioids can sometimes harm people.

    Posted by Andrew Kolodny | August 6, 2011, 6:46 PM
  4. I totally agree with it. Just now we are working on protocol in pain management for primary Health Care physicians , we have passed it to MOH for suggestions, and we hope it will be adopted. After we plan to implement it throughout the country, with with support oh the same MOH.
    With concerns the Dr. Volkow’s statement, I don’t know where she get her back ground education, it seems very similar of our former Director of the institute of Drug Abuse and the former MOH during Soviet Union and who has still big power on the issues regarding Narcotic Policy, when he states that of course these drugs must be available for medical reasons, but is against of any step to make them more accessible for pain control.

    (Ed: a palliative care MD in Georgia).

    Posted by patidzotsi | August 8, 2011, 5:42 AM
  5. The BMJ includes both a story on the USA drug problem and a separate piece on Dr Volkow. It may be of great interest to those of you from the former Soviet Union!

    I have included both links below. I don’t read at all that she is suggesting restricting access to those who need it for medical purposes. The reason I included this with the “Back to School” video, was her emphasis on education.

    Posted by Pain policy & palliative care | August 8, 2011, 8:35 AM

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