WHO releases statement regarding withdrawn pain guidelines
Palliative care organizations around the world felt that the withdrawal was a knee-jerk reaction, and that it should have followed consultations with experts. The WHO has released a statement in essence explaining the principle of balance, with which we would all agree. The Principle of Balance states that we have a dual responsibility – to make opioids available for pain relief, while at the same time preventing their diversion to inappropriate or non-medical use.
We hope the new guidelines will bring opioids back to their rightful place so that people are not left in agony of pain.
We have one concern, though. The new guidelines are going to be evidence-based. We hope any expert committee which goes into creation of these guidelines will take into consideration the fact that for some things as subjective as pain, the quality of evidence is bound to be of relatively poorer quality.
Secondly, the weight of evidence may turn greatly in favour of the more expensive medicines. This is inevitable because at least 80% of all scientific research is funded by the pharma industry directly or indirectly. Very little research actually happens globally regarding inexpensive medicines, which, we believe, are systematically pushed out of the market.
The Indian experience with Dextropropoxyphene is a case in point. Globally, everyone would frown at the name Dextropropoxyphene. Experts, otherwise led by reason and research, have been heard to claim that it is a ‘dirty drug’. We hope that those who have gone into the depths can recount a different story.
We hope the new evidence-based guidelines will not have a negative effect on people in pain, globally. Their numbers are unbelievably large. More than 80 million people globally die with untreated, excruciating pain.