The ESMO-led Global Opioid Policy Initiative (GOPI) project evaluated the barriers to the availability and accessibility of opioids recommending that policy reform is necessary worldwide to manage severe cancer pain and avoid unnecessary suffering by patients.
Within this project, ESMO and the European Association for Palliative Care (EAPC) conducted Consortium Studies in Europe and internationally on the availability of opioid analgesics for pain management using standards derived from the WHO and the International Narcotics Control Board (INCB).
The studies measured barriers and proposed recommendations to improve to access to opioids for legitimate medical use, including cancer pain.
They identified formulary deficiencies and excessive regulatory barriers which interfere with appropriate patient care in many countries. They revealed that urgent and intensive efforts to increase access to opioids for legitimate medical use are needed.
The survey results were used in ESMO policy initiatives to support the 2014 WHO Resolution on Palliative Care, where a joint statement by ESMO and other societies supported its successful adoption at the World Health Assembly.
ESMO supported a successful international initiative to ensure that the 2016 Outcome Document of the United Nations General Assembly Special Session on the World Drug Problem contained recommendation to ensure access to controlled substances, such as opioids, for legitimate medical and scientific purposes, while preventing their diversion.
These WHO and UN resolutions need to be fully implemented because adequate pain relief is a major goal of supportive and palliative care, especially for cancer patients. The WHO factsheet on palliative care state that only around 14% of the almost 57 million people in need of palliative care each year actually receive it due to unnecessarily restrictive regulatory barriers.
Read the publications below for more information on the results of the two ESMO studies and the analysis of the data collected:
- Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Europe: a report from the ESMO/EAPC Opioid Policy Initiative
- The Global Opioid Policy Initiative (GOPI) project to evaluate the availability and accessibility of opioids for the management of cancer pain in Africa, Asia, Latin America and the Caribbean, and the Middle East
The international study is accompanied by summary infographics and infographics by geographical region. A 10-point plan to reduce opioid access barriers proposes a solution for each barrier. It stresses the need for licensed physicians to have the required medical education, knowledge and skills to use opioid medications in the relief of cancer pain appropriately and safely as an integral part of high-quality healthcare. The plan recommends countries provide their citizens with at a minimum the palliative care medicines on the WHO Model List of Essential Medicines (See Section 2: Medicines for Pain and Palliative Care) for opioid formulary, which should include oral codeine, immediate-release morphine, controlled-release morphine tablets and injectable morphine.
To address the barriers and improve access and availability of opioids, united efforts between all stakeholders, including international organisations, authorities and regulators, is extremely important, and require particular focus on countries with the most severe restrictions.
ESMO acknowledges and thanks all coordinating, collaborating and supporting project partners for their valuable contribution to this project which made it such a great success.
Take action with the resources below
- Read the patient stories of lack of availability of pain medicines leading to untold and unnecessary suffering worldwide.
- Learn about the status of the availability of opioids in your country and region. Listen to the videos from across the globe
- Download the infographics representing the study results.
- Drive implementation of the 10-point plan to reduce opioid access barriers in your country, using the resources from the study which include summary information and infographics of the study results by geographical region, as well as links to editorials, advocacy materials, videos and much more.