In a paper published in Drug and Alcohol Dependence, a group of WHO experts determined when was the last scientific review of the substances controlled under the Single Convention on Narcotic Drugs and the Convention on Psychotropic Substances? Such a review can lead to a WHO recommendation to bring a substance under drug control – to remove or reschedule it.
They found that many substances were not reviewed for decades, including amphetamine, cannabis, MDMA, coca leaf, heroin, and the opioid analgesics hydrocodone and oxycodone. Twenty five substances were not reviewed since WHO took over this task from the League of Nations in 1948.
Morphine, opium and cocaine were never evaluated since the first Opium Convention was agreed on in 1912.
The scientific methods for review have developed and changed considerably over time. Therefore, outdated reviews undermine the legitimacy of drug control. As a remedy, the authors recommend a re-review at least every twenty years. They also provided a number of other recommendations to strengthen and speed up the review process and to acknowledge the differences in dependence producing properties between preparations that have slow vs. rapid kinetics. This could make a difference for access to analgesic medicines, as it is known that slow-release preparations are less likely to cause dependence and therefore some might be candidates for exemption from drug control.
E. Danenberg, L.A. Sorge, W. Wieniawski, S. Elliott, L. Amato, W.K. Scholten. Modernizing methodology for the WHO assessment of substances for the international drug control conventions. Drug and Alcohol Dependence 131 (2013) 175– 181. DOI: http://dx.doi.org/10.1016/j.drugalcdep.2013.02.032.
Courtesy of Dr. Willem Scholten, PharmD, MPA
Dr. Scholten is consultant in medicines and controlled substances