Video 4: The barriers to access to essential medicines

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En provenance du cours de University of Geneva

Drugs, drug use, drug policy and health

8 notes

University of Geneva

Drugs, drug use, drug policy and health

8 notes

This MOOC is the first of its kind, since it addresses critical issues related to drugs from a multidisciplinary, health and human rights-based approach. Throughout the course you will cover a range of questions including what are drugs and why they controlled? What are the benefits and harms of taking drugs? How public health policies can address drug use? You will also learn about the intricacies of the international drug control framework and the negative consequences of widespread prohibitionist drug policies around the world. Finally, you will examine ways of furthering drug policy reform. The topics will be presented by over 40 speakers from scientific, academic and institutional backgrounds, spokespersons of civil society as well as people who use drugs presenting their views. By the end of the course you will have: - a strong understanding of the major health issues related to drug use and drug policy; - a clear vision of why drug policy is debated today; - and, if you so wish, you will be equipped to engage in the drug policy reform movement at your local or regional level.

À partir de la leçon

MODULE 5: Medical access to opioids for the management of pain and to other controlled medicines

Welcome to Module 5 which looks at access to controlled medicines. During this week, you will learn how the international scheduling of drugs works; be presented with some of the main barriers to access to essential medicines and look specifically at the case of the opioid epidemic which is ravaging through the United States at the moment. The medical use of cannabis and cannabinoids is also a highlight of this week and one that is particularly relevant in a number of countries around the world at present. By the end of this Module you will be able to: • Describe the scheduling of controlled medicines; • Recognize the barriers to access to controlled medicines and discuss the challenges posed by prescription drugs epidemics; • and examine the current issues around the medical use of cannabis and cannabinoids. We hope you enjoy this week, which is slightly different to the other Modules in terms of its specific topic but adds a lot of important information in terms of understanding the international drug control framework and issues related to drugs, drug use and policies as well as possible. Best wishes,The Drugs, Drug Use, Drug Policy and Health team

Video 4: The barriers to access to essential medicines6:27

Video 5: The special case of the opioid epidemic in the United States6:25

Video 6: Medical use of cannabis and cannabinoids6:47

Video 7: The case for a revision of the international scheduling of drugs6:57

Rencontrer les enseignants

Michel Kazatchkine
Senior Fellow
Global Health Center, Graduate Institute for International Affairs and Development, Geneva
Barbara Broers
Professor (in Addiction Medicine)
Community Health Departement, Geneva University Hospitals
Jennifer Hasselgard-Rowe
Researcher and Lecturer
Institute of Global Health, University of Geneva
Aymeric Reyre
Senior Lecturer
Faculty of Medicine, Paris 13 University

The question you're asking is what are the obstacles,

the barriers to access to essential medicines and

specifically to opioids for the treatment of pain?

Well, my answer is that this is indirectly

a negative consequence of the way drugs are controlled.

Its a negative impact of Prohibition.

Just think of the 1961 conventions.

In the preamble to the conventions,

it is said that these conventions are there to promote the welfare,

the well-being of the population.

The original intention is to prevent the diversion of drugs for nonmedical use but

also to promote the use for medical purposes of the drugs,

medicines that are needed by people.

However, what has happened is that because of prohibition,

because of the way the Conventions have been interpreted,

most governments have put all of their money and their energy in actually

preventing diversion in criminalizing drugs,

criminalizing use, incarcerating, arresting people,

rather than actually promoting these medicines for the people in need.

So, what do I mean by that?

First, the system has put limitations and

a huge bureaucracy behind the prescription of these medicines for people in need.

Special forms, limitation in how much you can prescribed,

for our long you can prescribe,

availability of the drugs is maybe a problem.

I've seen in some countries in Ukraine for example that you

actually need an armored convoys to

bring the medicines from the Central Store to a hospital or to a methadone clinic.

So, these drugs are treated like something special and something potentially dangerous.

Then the doctors themselves.

In many countries, they actually fear that if they over-prescribe,

if they do not prescribe in the right way,

they will be punished or they will be prosecuted by the system.

Finally, the patients and their families themselves have

such a misconception about what morphine

can be because of the overlaps because of the ambiguity

of these substances being both medicines and illegal drugs,

that families themselves may be reluctant that the idea that the doctor will prescribe.

"Doctor will my brother become an addict?

Are you sure he needs even morphine?"

Now, that's the question I have been asked so many times whereas

whenever a medicine that is well prescribed is a medicine that

is prescribed when it is needed and not prescribed when it is not needed.

Sorry to state the obvious,

but when it is needed,

everything should be done so that the patient access it,

and I'm absolutely convinced that the misconceptions,

the myths we have in society around these substances,

and that the priority given to control of diversion,

over promotion of health,

has really been unhelpful here,

and that's one of the main reasons,

direct and indirect why 85 percent the people in

the world do not have access to these medicines when they need them.

One of the concerns I have though here is that

the recent opioid epidemic in the US and in

Canada will not help us in our fight for access

to essential medicines and opioids for the treatment of pain,

because that may be seen as look at what happens if these drugs are too easily available.

But when you think of it,

they're too easily available because they have been poorly prescribed,

because they were advertised on TV,

because they were poorly regulated.

So to me, bringing this issue of the access to medicines and the issue of moving to

legal regulation of what is currently illicit drugs

in general converges somehow to one concept,

a properly and adequately regulate these substances.

Regulate these substances just as we regulate anything that can potentially be dangerous,

be it preservatives in food,

be it a medicine,

be it a radio isotope,

be it as I often say, a car.

It's dangerous to drive cars,

but you put on a safety belt,

you drive carefully on the right side of the road.

If things are regulated,

that's the way a society address something that is risky and potentially dangerous.

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