International drug control treaties not only recognise the dangers associated with abuse of and trafficking in narcotics drugs, but they also recognise that they are indispensable for the relief of pain and suffering. Narcotic drugs, including opiates, have a variety of medical uses. They are used as an anaesthetic or analgesic, and to treat diarrhoea, cough or narcotic addiction, as well as for veterinary, dental and laboratory purposes. The International Narcotics Control Board, in cooperation with governments, endeavours to ensure that there is an adequate supply of narcotic drugs for medical and scientific purposes and to limit their production and use only to such purposes in order to prevent illicit narcotic drug production, trafficking and use.

The Economic and Social Council, in its resolution 1989/15, requested the Board to pursue the early finalisation and implementation of a project to assess legitimate needs for opiates in various regions of the world, hitherto unmet because of insufficient health care, difficult economic situations or other conditions. In 1989, the Board, in cooperation with the World Health Organisation (WHO), issued a special report entitled Demand for and Supply of Opiates for Medical and Scientific Needs. In that special report, the Board concluded that the medical need for opiates, particularly that related to the treatment of cancer pain, was not being fully satisfied. It recommended that Governments should critically examine their methods of assessing domestic medical needs for opiates and of collecting and analysing data, so as to make the changes required to ensure that future estimates would accurately reflect the actual need. It also recommended that Governments should examine the extent to which their healthcare systems and laws and regulations permitted the use of opiates for medical purposes, should identify possible impediments to such use and should develop plans of action to facilitate the supply and availability of opiates for all appropriate indications. Subsequently, the Council, in its resolutions 1990/31 and 1991/43, requested the Board to accord priority to monitoring the implementation of the recommendations contained in its special report.

In response, the Board has prepared the present special report, again in cooperation with WHO, to ascertain whether Governments have fully implemented the recommendations contained in its special report of 1989, to identify Governments that have not yet fully implemented the recommendations, as well as their reasons, and to propose measures to improve the availability of opiates for medical purposes. The present special report includes a survey of all Governments, as well as inquiries to WHO and professional organisations. Sixty-five (31 per cent) of 209 Governments responded to the survey.

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