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Overzealous regulation of opioids is having a painful knock-on effect on eastern Europeans with cancer.

“There are literally tens of thousands of people who are suffering unnecessarily,” says lead author of Shaare Zedek Medical Center in Jerusalem, Israel.

Opioid-type drugs are potent painkillers. In fact, the World Health Organization lists two of them, codeine and morphine, as that should be available worldwide.

Cherny and his colleagues asked cancer pain specialists, including doctors, nurses and social workers from 40 European countries plus Israel, to review access to opioids in their countries.

They found that tens of thousands of cancer patients in several former Soviet bloc countries can’t easily get the drugs because of laws aimed at preventing a black market in opioids. In Ukraine, for example, patients are only allowed a day’s supply of medicine at a time, while in Georgia they must get a stamp from a police station to obtain painkillers.

Loosened restrictions

at the Pain and Policy Studies Group in Madison, Wisconsin, is hopeful that laws will soon be relaxed in some eastern European countries.

Romania loosened restrictions on opioid painkillers in 2005 after . Similar efforts are under way in Moldavia, Georgia, Armenia and other countries where access to opioids is restricted.

Cherny’s team found fewer restrictions on opioid painkillers in western Europe. But outside the US, Canada and Australia, the situation in the rest of the world is similar to eastern Europe’s or worse, Cleary says. “Ten countries consume 80 per cent of the world’s opioids.”

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