Essential medicines and health products

Access to Analgesics and to Other Controlled Medications

Although necessary, drug control regulations, if overly restrictive, can hamper access to controlled medicines for therapeutic use. A balance must therefore be struck between medical and regulatory requirements.

For over 50 years the focus has been on the prevention of abuse. This has led to overly strict rules or inappropriate implementation of the international drug control treaties in many countries. As a result, the medical use of controlled substances has been hampered and in some cases prohibited. Another consequence is that misconceptions have spread based on the unjustified fear that opioid medication may cause dependence or death in patients.

Many countries have neglected their obligation under the UN Conventions to provide sufficient access to analgesics. These obligations are reinforced by many international bodies, i.e. the International Narcotics Control Board (INCB), the United Nations Economic and Social Council (ECOSOC), and the World Health Assembly (WHA).

Severe under-treatment is reported in more than 150 countries, both developing and industrialized, accounting for about 80% of the world's population. Annually, up to 10 million people suffer from lack of access to controlled medications. Nearly 1 billion of those living today will encounter this problem sooner or later. Most of them will be pain patients, others will be suffering from other conditions. The impact of impaired access to these medications is extremely serious.

After being invited in 2005 by the Convention on Narcotic Drugs, ECOSOC and the WHA to study the feasibility of assisting countries improve access to opioid analgesics, WHO developed the Access to Controlled Medications Programme (ACMP) in consultation with the International Narcotics Control Board (INCB). The Programme aims to improve legitimate medical access to all medications controlled under the drug conventions.

WHO Briefing notes: Access to Controlled Medications Programme

Improving access to medications controlled under international drug conventions

Component: Developing WHO Clinical Guidelines on Pain Treatment

Resources on Availability of Controlled Medications