A new analysis has shed light on "a pandemic of intolerable pain affecting billions" of cancer sufferers caused by medicines over-regulation.

The Global Opioid Policy Initiative (GOPI) project has been led by the European Society for Medical Oncology and involved 22 international organisations. This is the largest study of its kind, carried out in 79 countries and 25 Indian states, representing more than five billion people.

The study, published in Annals of Oncology, was conducted in Africa, Asia, Latin America and the Caribbean and the Middle East and assessed the availability of the seven opioids considered to be essential for the relief of cancer pain by the World Health Organisation -  codeine, oral oxycodone, transdermal fentanyl, immediate and slow-release oral morphine, injectable morphine and oral methadone. It notes that while there are problems with the supply of these medicines in many countries, "the main problem is over-regulation that makes it difficult for healthcare professionals to prescribe and administer them for legitimate medical use".

As a result, "more than four billion people live in countries where regulations leave cancer patients suffering excruciating pain", according to GOPI. Nathan Cherny from the Shaare Zedek Medical Center in Jerusalem and lead author of the report, said it has uncovered "a pandemic of over-regulation in much of the developing world that is making it catastrophically difficult to provide basic medication to relieve strong cancer pain".

He added that "this is a tragedy born out of good intentions" but when opioids are over-regulated, the precautionary measures to prevent abuse and diversion "are excessive and impair the ability of healthcare systems to relieve real suffering". Dr Cherny goes onto say that "when one considers that effective treatments are cheap and available, untreated cancer pain and its horrendous consequences for patients and their families is a scandal of global proportions".

Co-author James Cleary of the UW Carbone Cancer Center in Wisconsin, said that the next step is for international and national organisations working alongside governments and regulators "to thoughtfully address the problems". He added that regulatory reform "must be partnered with healthcare providers education in the safe and responsible use of opioid medication, education of the public to destigmatise opioid analgesics and improved infrastructure for supply and distribution".