Six Countries Consume 80% of World’s Morphine

There is an article in the NYTimes today addressing the availability of narcotic pain medication in  poorer countries.  The author reveals the following shocking statistics,

Six countries — the United States, Canada, France, Germany, Britain and Australia — consume 79 percent of the world’s morphine, according to a 2005 estimate.

In 2004, consumption of morphine per person in the United States was about 17,000 times that in Sierra Leone.

I italicized “shocking” to coat my words in a gooey layer of sarcasm.  Firstly, such statistics are rather baseless unless adjusted for population sizes.  Secondly, I don’t think anyone would expect the percentage to be anything but, or possibly more than, 80%.  Though I am too lazy to do the research, I bet the US consumes 80% of at least 10,000 types of  commodities/drugs/staples in the world.  These countries are a rich, privileged, consumer cultures with fancy healthcare systems.  Why would one expect Sierra Leone to have equal narcotic access?

Perhaps the article is meant to raise awareness?  What is the harm in bringing a public health issue into the public eye?  Ahh, but the devil is in the details.  The questionable thesis proposes that narcotic pain relief is denied on cultural stigma, not on economics.

…She cannot get morphine…That is not merely because of her poverty, or that of Sierra Leone. Narcotics incite fear: doctors fear addicting patients, and law enforcement officials fear drug crime.

The “opioid phobia” thesis jumps the cause of the problem; it casts a fundamentally economic problem in an artificial, societal light.  I would like to accept the idea that drug wars and human rights violations have created a narcotic taboo, since it’s (arguably) easier to enact social change than economic change.  The situation is strikingly similar to the world described in Anne Fadiman’s The Spirit Catches You and You Fall Down.  Poverty creates a harsh environment for Western medicine to thrive.   The governing bodies in places like Waterloo do not sit about a roundtable and mull the possibly-addictive side effects of legal narcotic pain medication.  They have far bigger crises–of the economic kind–which need addressing first.  Many people in Africa indeed deserve pain relief from cancer, but many many more  deserve food, contraception, malaria relief, wages, and basic human rights.  Put these things in place first.  The opioid phobia would dissolve in the face of economic and social stability.

The author rightfully states that the cost of morphine is not the bottleneck, but blames the effect (the narcotic taboo) instead of the cause (poverty).  It’s also unfair to frame the issue in terms of the evil, rich, fat, Americans, hogging the world’s resources.  The author introduces the shortage as one of unfair distribution (we cosume 17,000 times the morphine!), but later states there is no shortage of opium to make the drug.  It’s all a fancy way to tiptoe around the fact that poverty drives the health care problem in Africa.

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~ by wcuk on September 11, 2007.

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