A recently published article in the Journal of Pain & Symptom Management highlights the important progress being made towards the safe accessibility of opioid medicines in Vietnam.
The article focuses on the work accomplished through the Pain & Policy Studies Group’s International Pain Policy Fellowship (IPPF) by Madame Nguyen Thi Phuong Cham, formerly a pharmacist in the Ministry of Health in Vietnam, who was selected as a Fellow in 2006 and by Dr. Khue, a colleague from the MoH, who accompanied her to the fellowship training and provided ongoing support throughout the project. The Fellow and her colleague were supported by mentoring from PPSG founder Mr. David Joranson and Dr. Eric Krakauer, a mentor for the IPPF.
Together this team employed a balanced policy method devised for the IPPF that involved working with committed local colleagues to review all Vietnamese policies governing opioid accessibility to identify the barriers; developing an action plan to safely address the barriers; garner support for the plan from all stakeholders, including drug regulators and the police; and assisting the MoH to implement the plan.
Some important positive outcomes of this work include:
- The MoH issued amended Opioid Prescribing Regulations for treating pain improving access to opioids by removing a maximum dose of opioids per day and allowing pain patients, in addition to cancer and AIDS patients, to receive an opioid prescription for up to 7 days per prescription,
- the Drug Administration of Vietnam (DAV) revised its regulations on Procurement, Purchase, Distribution, Storage, and Dispensing of Narcotic and Psychotropic Drugs – removing tight restrictions on the number of pharmacies allowed to dispense opioids,
- Morphine consumption has increased each year, and as of 2010 was nine-fold greater than in 2003, and
- the number of hospitals offering palliative care has increased from 3 to 15.
Such progress in Vietnam demonstrates that a developing country can improve accessibility to opioid medicines despite a strong socio-historically based tradition of opiophobia.