Cancer patients die agonizing deaths due to lack of awareness on morphine usage

Cancer patients die agonizing deaths
due to lack of awareness on morphine usage

C Shivakumar

Chennai:

India produces 97 per cent of legal morphine globally but only three per cent is used by over one million Indians, who endure cancer pain and die agonizing and undignified deaths due to lack of awareness, according to Cancer Institute Chennai.

E Vidhubala, Assistant Professor and Principal Investigator, Department of Psycho-oncology and Tobacco Cessation Centre, Cancer Institute (WIA), Adyar told Express that India has been strongly criticized by the World Health Organisation for failing to incorporate adequate pain management into its palliative care programs.

Ruing the fact that the state has only 25 licence holders, Vidhubala said that there is a need for more licence holders in the state to access morphine. She said to address the issue of lack of morphine in the state, the Cancer institute is organizing an orientation and consultation meeting on enhancing morphine utilization on Wednesday.

Despite India’s heavy cancer burden, it consumes far less morphine than most countries. “The country supplies much of the opium to make morphine for increasing use in the rest of the world, but it produces very little for domestic use due to lack of demand,” she rued.

While the average morphine consumption in the country should be 900 kgs, the current consumption is only a meager 120kgs, according to the International Narcotics Control Board.

“While morphine consumption is increasing in most of the world, in India morphine consumption has decreased.  India was using 0.395 mg/capita in 1984, reduced to 0.095 mg/capita in 2009,” she added.

The World Health organization strongly recommends morphine as the opioid of choice for excruciating pain often suffered by terminally ill cancer patients, AIDS and other progressive life threatening illnesses.

“In palliative care and hospice, morphine is most often considered the “gold standard” of pain medications. It does a good job of treating pain in most patients and is usually well-tolerated and cost-effective. Morphine is also effective in treating dyspnea, or shortness of breath,” she added.

Cancer Pain – Facts

•    10 lakh new cancer patients are diagnosed every year in India.

•    60 per cent are diagnosed in advanced stage, requiring pain management and palliative care.

•    30 per cent-50 per cent have pain at the time of diagnosis.

•    70 per cent to 90 per cent have severe pain when the disease is advanced.

•    40 per cent die with severe pain.

•    60 per cent- 80 per cent complain of inadequate pain relief by their physician.

•    30 per cent are not relieved by drug treatment alone and require interventional pain management.

•    More than 90 per cent cancer pain can be adequately controlled.