Professionals who understand both cancer pain problems and the drug regulatory system are better prepared to take actions to address barriers to opioid availability. A systematic process should be used, beginning with the identification of the barriers in a particular country or province. After barriers to availability are identified, an action plan should be developed to remove them. The appropriate individuals or organizations should contact government agencies, policy makers, pharmaceutical manufacturers, and other private industries to begin a dialogue that leads to mutual understanding and change. The goal is to achieve a positive regulatory climate that clearly recognizes the rational use of opioid analgesics to manage cancer pain.
Drug abuse is a reality throughout the world.
Regulators and health professionals must share the responsibility for preventing diversion of opioids to illegal uses. All professionals who use controlled drugs should follow reasonable procedures to prevent diversion. The number of cases in which prescription morphine was seized by police was less than 10 per year during this five-year period. The use of opioid analgesics can increase significantly without increases in opioid diversion and abuse, if reasonable controls are exercised during drug distribution. If diversion occurs, the answer is to stop those responsible for diversion, not to limit the necessary medical supply or distribution of opioids to patients.