Pain Control for People with Cancer and AIDS

Abstract

The undertreatment of chronic pain is a global problem, especially for people in the final stages of cancer and, increasingly, AIDS. The pain of dying is often severe, but it can be controlled for most people by a simple and inexpensive intervention: oral analgesic drugs, including morphine and other opioids. Although it was long known that opioid drugs were essential for the relief of moderate to severe pain, even in the 1980s the amounts being used globally were so low that only a minority of those dying could have had adequate pain relief. Since then progress has been made, mainly in resource-rich countries, widening the gap between rich and poor. The absence of opioids in developing countries is not merely a problem of supply or costs, however. This chapter lays out the institutional and political barriers that restrict their availability in most low- and middle-income countries.