Growing inequality in the availability of pain relief drugs between developed and developing countries has spawned an escalating abuse of pain relief drugs in the former, which in some cases has even exceeded the level of abuse of illicit drugs, says the Vienna-based International Narcotics Control Board (INCB).

In its annual report, released worldwide on Wednesday, the Bureau said that this has come at a time when “more than 80 per cent of the world's population has no or insufficient access to pain relief drugs and are suffering unnecessary pain because of it.”

Lop-sided consumption

Stating that 90 per cent of the licit drugs are consumed by 10 per cent of the global population in the US, Australia, Canada, New Zealand and some European Countries, the President of the INCB, Mr Hamid Ghodse, highlighted the grim reality as to how many countries in Africa, Asia and parts of the Americas have very little or no access to narcotic drugs and psychotropic substances for medical purposes and treatment.

Even as the lack of availability of controlled medicines could deprive patients of their right to health benefits and relief from pain and suffering, the report cautioned that “excessive availability could lead into abuse and subsequently drug dependence.”

Diversion

Reminding member governments including India of the need to remain vigilant in identifying and addressing new trends in the diversion of precursor chemicals intended to be used in the illicit manufacturing of drugs, the report said criminal networks the world over have demonstrated their “adaptability in modifying their diversion and production methods in order to circumvent stricter control measures adopted by national governments.”

It documented how South Asia has become one of the main regions used by drug traffickers to obtain the chemicals needed for the illicit manufacture of methamphetamine, namely ephedrine and pseudo-ephedrine. Indian law enforcement agencies seized 1.2 tonnes of ephedrine in 2009 and India increasingly uncovers facilities where methamphetamine destined for markets in other countries is illicitly manufactured.

India a source

While Bangladesh is being targeted by criminal networks as a source of pharmaceutical products containing these precursor chemicals, it said pseudo-ephedrine from India is also formed into tablets in Bangladesh before being sent to Central America and the Caribbean. It further noted that India is one of the main sources of psychotropic substances sold through illegal Internet pharmacies.

Pointing out that the vast profits generated in the illicit drug markets often exceed the financial resources of state institutions, the report said “the very authorities established to control and repress drug trafficking are themselves compromised by corruption.” While European countries consume half of the heroin worldwide, almost all heroin available in Europe originates from Afghanistan, it said adding that the Russian Federation has the highest level of opiate abuse (1.6 per cent) in Europe.

Designer drugs

The report also highlighted the rapid development of new designer drugs, which are produced to bypass existing control systems and said these drugs of abuse are often manufactured by slightly modifying the molecular structure of controlled substances, resulting in a new substance with similar effects which could circumvent national and international control measures.

Citing one such designer drug 4-methyl-methacathinone, known as “mephedrone” as having been abused in a growing number of countries and regions, it said this substance has resulted in a number of death as it has effects akin to cocaine, amphetamine and MDMA (ecstasy). It has now become a problem drug of abuse in Europe, North America, South-East Asia and Oceania (in Australia and New Zealand).

INCB urges its member governments to place these new substances under national control, in order to be able to prosecute the individuals involved in their manufacture and distribution. Where possible, it said, governments should consider generic scheduling to control entire groups of such substances.

Finally, it said the availability of herbal mixtures containing synthetic cannabinoids—correctly termed ‘synthetic cannabinoid receptor agonists'—have psycho active effects akin to cannabis. But, it said, while cannabis is globally controlled under the 1961 Single Convention on Narcotic Drugs, synthetic cannabinoids are not under international control.

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