Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Palliative Care Medicines, reports on some key advocacy work in which she has been involved during the past month.
February has been a little quieter than usual with no major trips or meetings for me, but I did return to Baltimore for a few weeks to serve as a live-in caregiver for my younger sister, who is suffering from a slow-growing brain tumor, thirty years after having had much of it excised and irradiated. She is not acute, but needs constant oversight in case of falls, as well as assisted daily living. Although I have been a hospice volunteer for non-family members, it is a different experience to be a hands-on caregiver for a family member with serious illness. It gives me more personal insight for my advocacy work. I particularly think of, and pray for, carers who are financially and physically challenged as they do this work, in environments that are not wheelchair friendly and lacking in essential medicines and good home help services.
In mid-March I will attend the annual (60th) Commission on Narcotic Drugs meeting, where there will be a ‘gala’ side event hosted by multiple country missions and UN agencies on access to controlled medicines. Dr. Lukas Radbruch, chair of the IAHPC Board, and Dr. Jim Cleary, Executive Director of the Pain and Policy Studies Group at the University of Wisconsin, will be two of the expert panelists. I will welcome the audience on behalf of civil society and the Vienna NGOC (Non-Governmental Organizations Committee on Drugs), of which I am vice-chair. VNGOC will also host a side event on drug policy and the Sustainable Development Goals, which will include discussions on access to palliative care and controlled medicines in the context of Universal Health Coverage.
The past few weeks have also been spent coordinating the production of a two-page information sheet, to be distributed at CND and elsewhere, on the principle of balance and the ‘twin opioid crises’ — the crisis of underconsumption, wherein patients and providers in many countries have inadequate access to controlled medicines for pain and palliative care, and the crisis of overconsumption, where prescription medicines – mainly strong opioids – are not used as prescribed, or are consumed by people other than those for whom they were originally prescribed. Many prescription opioids in countries such as the US, Canada, and Australia are “diverted or abused” in the language of the drug control system, taken with benzodiazepines, other drugs, and/or alcohol, resulting in fatal overdoses.
As what the media calls the ‘US opioid overdose epidemic’ is having a chilling effect on international, national, and regional advocacy efforts to improve access to controlled medicines in low consumption countries, a consortium of global, regional, and national palliative care organizations, including the IAHPC, collaborated to produce an informational response. We drafted a short paper on the topic with the WHPCA (Worldwide Hospice Palliative Care Alliance), ICPCN (International Children’s Palliative Care Network), PPSG (Pain and Policy Studies Group) the ALCP (Latin American Palliative Care Association), APCA (African Palliative Care Association), Pallium India, KEHPCA (Kenya Hospices and Palliative Care Association), EAPC (European Association for Palliative Care) and the UICC (Union for International Cancer Control). The directors of all those organizations read and made suggestions for the text of the paper, called ‘Access to Controlled Substances for Medical and Scientific Purposes: Ensuring and Restoring Balance’. All have endorsed it for distribution. This was a terrific global collaborative response in the face of these twin crises of availability of controlled medicines. See here for the paper – please read and share widely.