The Drugs Controller of Kerala has published an order (No.1370/2021/DC 19.03.2021) making online training adequate for a doctor to be in charge of stocking and dispensing morphine and other step 3 opioids in any recognised medical institution. The order in Malayalam can be translated as: “Online training in pain and palliative care management is approved for getting RMI status”.
When the Indian parliament amended the Narcotic Drugs and Psychotropic Substances (NDPS) act in 2014 and published the relevant rules in 2015, it was mentioned that for any healthcare facility to be considered a recognised medical institution, it should have one doctor with training in pain management. The nature of the training was not specified in the rules. Therefore, it is now left to the discretion of the drug controllers of individual states to decide what is eligible training. In Kerala, 10 days of clinical training had been considered mandatory for many years.
When that clause was brought in, there was an understanding that this would be necessary only so long as doctors continue to be unfamiliar with opioid medicines. From 2019, medical students formally learn pain management as part of their curriculum. In 2020, when Covid19 brought a halt to all physical courses and virtual education became the order of the day and as educators developed the ability to impart knowledge and skills using online platforms, the need for changing strategy came apparent. Thank you Mr Narayanan Puthukkudy, president of Kerala chapter of Indian Association of Palliative Care for facilitating this action by the drugs controller of Kerala.
Understandably this is now applicable only to Kerala. But we will now be able to quote this as precedence for adoption by other state drugs controllers too.