Access without excess: how to ensure safe, balanced access to controlled medicines around the world - Call for contributions

Many opioid medicines like morphine, codeine, fentanyl, and oxycodone are considered essential for providing basic health services by the World Health Organization (WHO). Yet the vast majority of the world’s population, particularly in low- and middle-income countries (LMICs), does not have adequate access to these medicines. It is estimated that 80% of the global production of morphine is consumed in countries/regions with less than 1% of the world’s population.

This topic collection aims to bring together a series of papers, both review articles and original research, addressing the global challenge of opioid access and the development of evidence-informed policies to achieve equitable, safe, and sustainable pain management.

Many countries choose to restrict access to controlled medicines due to insufficient control mechanisms in the production, import, distribution, storage, prescription, and consumption stages. At the same time, several high-income countries have experienced well-documented public health crises relating to the overmarketing and overuse of pain medicines. While there is increasing global recognition of the need for equitable access to controlled medicines, the pathway to developing evidence-informed guidance and policies in the various settings in which they are needed remains challenging. This is in part due to a substantial amount of recent scientific literature being published around opioid deprescribing initiatives in the North American context, and a relatively low proportion of scientific literature from LMICs on the need for access. In addition, while there is a significant body of literature exploring new applications of emerging medicines from high income countries, there is a limited evidence-base from LMICs. Topics of interest include (but are not limited to):

• Global patterns of opioid availability and consumption
• Barriers to access in LMICs, including regulatory, cultural, and health system constraints
• Strategies to balance access and control in opioid regulation
• Evidence-based policy development for equitable pain management
• Lessons from high-income country experiences with opioid overuse and deprescribing
• Health system strengthening and capacity-building for safe opioid distribution
• Innovative approaches to pain relief, including emerging medicines and delivery systems

Please see the instructions for authors for submission requirements for each article type. To submit your article, please follow these instructions and select ‘Access without excess: how to ensure safe, balanced access to controlled medicines around the world’ as the Topic Collection. All submitted articles will be subject to the journal's normal peer review process. The Editor in Chief is responsible for the content of this Topic Collection. Guest Editors will manage peer review, invite reviewers and make a recommendation, but the final decision on all manuscripts will be made by the Editor-in-Chief. Articles accepted for publication will be published upon acceptance. Visit our author hub for more information regarding the publication process for topic collections. Authors submitting to this Topic Collection are entitled to a 25% discount on the Article Processing Charge. Discount is available upon request to info.bmjgh[@]bmj.com. For any inquiries regarding this topic collection, please contact topic.collections[@]bmj.com.