Breakthrough: Morphine as a human right

When I was 10 my soccer team played an end-of-the-season scrimmage, with the team's two coaches playing opposing goalies. I normally played center half-back, not forward, but somehow I ended up with the ball and began to drive toward the goal. The next thing I know I'm trying to slide past my 220+ pound coach for the shot, he falls on me, and people from across the park hear the bones in my lower leg snap.

The pain was unlike anything I had ever known: my tibia and fibia and both snapped in half, like campfire kindling, and my left foot was sort of flopped over limply to the side.

For some reason, I didn't go into shock. Everyone gathered round and did the best they could to comfort me until the ambulance came.

I begain asking for pain relief as soon as I was on the ground. People said to wait for the ambulence. As soon as the paramedics started to work on me, I asked for pain medication. You'll have to wait until the hospital, they said. As soon as I entered the ER, I begged my mother to demand pain medication.

The pain was everything -- it created my entire world. I could think of nothing other than making it go away. It hurt so bad I couldn't t even cry -- it was as though I was saving all my energy just to withstand the agony.

A few years later, when I was fifteen, I started an Amnesty International chapter in my high school, in part because I was really into Sting at the time (who was an Amnesty celeb-spokesman) and in part because the personal testimonials I had read of torture victims struck a chord for me: I could remember my own pain and didn't want anyone else to experience such a thing.

Today, the Times has an eye-opening piece on lack of morphine and other narcotics in poor African countries. The photo on the front page is of a woman dying of breast cancer who can't get narcotics. If "poverty" is largely an abstraction -- a constellation of things, like inadequate health care, housing, opportunity, food, etc. -- pain is concrete, and a pretty darn good basis for solidarity.

Figures gathered by the International Narcotics Control Board, a United Nations agency, make it clear: citizens of rich nations suffer less. Six countries -- the United States, Canada, France, Germany, Britain and Australia -- consume 79 percent of the world’s morphine, according to a 2005 estimate. The poor and middle-income countries where 80 percent of the world’s people live consumed only about 6 percent.

Of course, there are always alternatives to pain relief:

At pain conferences, doctors from Africa describe patients whose pain is so bad that they have chosen other remedies: hanging themselves or throwing themselves in front of trucks.

As it turns out, the culprit isn't just poverty -- after all, narcotics aren't all that expensive to manufacture -- it's also the war on drugs.

"It's the intense fear of addiction, which is often misunderstood," said David E. Joranson, director of the Pain Policy Study Group at the University of Wisconsin’s medical school, who has worked to change drugs laws around the world. "Pain relief hasn't been given as much attention as the war on drugs has."

Anyone who has experienced real pain, and even those who haven't but can imagine it, would agree that pain treatment should be viewed as a fundamental human right. It's probably one of the most important things that distinguishes us from other animals: we can self-medicate.

Let's hope not only that the Bonos, Buffets, and Oprah's of the world champion pain relief in their anti-poverty crusades, but also that Amnesty International starts to see the excesses of the drug war for what they are: human rights violations.

Well said, Michael!

You got it right. The obstacles to effective pain management are much the same as the obstacles to dealing more sensibly, effectively and humanely with drug use and misuse. It's the lethal combo of drug war ideology and drug mythology, in this case the pervasive "opiophobia" described in the NY Times article.

Change will come, but only if we're successful in correcting the ignorance and transforming the attitides that fuel the drug war.

Ethan Nadelmann

Executive Director

Drug Policy Alliance

70 West 36th Street, 16th floor

New York, NY 10018

PH: 212 613 8061 FAX: 613 8021

http://www.drugpolicy.org

mailto:enadelmann@drugpolicy.org

Posted by: Ethan Nadelmann at September 10, 2007 9:51 PM

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