Judy Foreman

A Nation in Pain

The Global Pain Crisis

Millions of people around the world live—and die—in pain, without morphine.

Posted May 24, 2017

You’ve probably seen the dramatic photo of the Ohio couple slouched, overdosed, and passed out in the front seats of a car, with a little kid sitting in the back seat. 

Even if you haven’t seen that picture, images and words of America’s opioid overdose epidemic have captured headlines and TV news feeds for the last several years.

But there’s a different image seared into my mind, a mental picture of a different little kid and two adults. This one never made it into the news, but it’s just as real. I can’t get this “picture” out of my mind ever since I wrote about it for my new book, The Global Pain Crisis: What Everyone Needs to Know.

It took place in India, on June 1, 2014. The little boy in this scene had been suffering unbearable pain for most of his eight years, pain triggered by a severe genetic disorder. The hospital he was in, like most hospitals in India, had no morphine.

Eventually, the parents did the only thing they could think of to stop his pain. They killed him. Then they committed suicide, leaving behind a note saying they could not stand to watch him suffer any longer.

In this country, mention the word “opioid” and people think “overdose,” “abuse” or “death.”  But in much of the rest of the world, the problem is quite different: A massive shortage of available morphine for millions of people suffering in pain, people like this Indian boy.

Morphine costs just three cents a dose. It is safe, when used properly, and effective. Yet tens of millions of people around the world suffer in pain because of the lack of access to controlled medicines, according to the World Health Organization. That’s not just people at the end of life, but people who’ve had accidents or been the victims of violence, people with chronic illnesses, people recovering from surgery, women in labor.

In some countries, according to Treat the Pain, part of the American Cancer Society, the situation is truly desperate. Take Ethiopia, a nation of 90 million people. For that huge population, there is only one ward (with 10 beds) offering morphine in the entire country.

The problem, which I explore in my book, is excessive regulations governing morphine and other “essential medicines.” Back in 1961, the world community adopted an international agreement called the Single Convention on Narcotic Drugs, which then set up the International Narcotics Control Board.

The board has two jobs. One is to control drug abuse and diversion. The other is to ensure access to opioid drugs for people in pain. Essentially, it only does the former. Yet failure to treat pain amounts to “torture by omission” in the eyes of some medical ethicists.

Clearly, as the tragic Ohio photo shows, there is a need to curtail abuse of opioids. But there is also, just as clearly, a need to make morphine and other powerful pain-relievers available to the millions of people who need them.

With all the other tragedies competing for the world’s attention—war, terrorism, dictators, economic problems—the lack of access to morphine never makes it to the headlines.

But it should. There is no question that we should try to keep powerful drugs out of the hands of would-be abusers and that we should provide much better treatment for people who become addicted.

There is also no question that a little boy in India should have had access to morphine. His death, and the deaths of his parents, didn’t make the news.

I wish it had.