In April, the United Nations General Assembly will review the international response to drugs for the first time in 18 years. An issue that has been neglected for decades – ensuring access to controlled substances for medical treatment, such as pain relief—has finally made its way on to the agenda. Dealing effectively with this issue will require profound changes in how most countries and the UN deal with drugs.

There’s a paradox at the heart of the issue: Some substances that are strictly controlled because they can cause harm are also critical to providing relief to millions suffering chronic pain and treating other health conditions. Consider, for example, the role of morphine, chemically a cousin of heroin, but also used to treat cancer pain.

The UN drug control conventions recognize that controlled substances are “indispensable for the relief of pain and suffering” and that countries must make “adequate provision” to ensure their availability for medical use. Yet, in the heat of the ‘war on drugs’ many countries – and much of the UN machinery – have focused primarily on rooting out illicit use and neglected the need to ensure medical availability of these substances.

The consequences have been disastrous. A new report of the World Health Organization estimates that 5.5 billion people live in countries with “low or non-existent access to controlled medicines for the treatment of moderate to severe pain.”

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Thumbnail: Wikimedia Commons - Creative Commons Licence - Copyright Ralf Roletschek