More than half the world’s population lives in countries where regulations aimed at stemming drug misuse are leaving cancer patients without access to opioid medicines for managing cancer pain, researchers have claimed.

More than four billion people live in countries where such regulations are leaving patients suffering from “excruciating pain,” says the Global Opioid Policy Initiative (GOPI), the first global survey to evaluate the availability and accessibility of opioids for cancer pain.

The project is led by the European Society for Medical Oncology (EMSO), which calls on national governments to take “urgent action” to improve access to these medicines. 

“The GOPI study 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,” says lead author Nathan Cherny, chair of the ESMO Palliative Care Working Group. “Most of the world’s population lacks the necessary access to opioids for cancer pain management and palliative care, as well as acute, postoperative, obstetric and chronic pain,” says Dr Cherny, who describes the situation as “a tragedy born out of good intentions.”

“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,” he says.

Ongoing initiatives to reform regulations, improve accessibility and promote the education of clinicians and consumers in the effective use of opioid medications for the relief of cancer pain will require vision, determination and a spirit of cooperation between organisations, say the authors, who call on government to “look at the GOPI survey data for their country and take concrete actions to reduce the barriers.”

“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,” says Dr Cherny.

The findings of the GOPI study have been published in the Annals of Oncology.