Access to Opioids: a fairytale?

War on Drugo

In my last academic year of MSc Global Health Policy at LSHTM (as a Distance Learner) I have chosen three modules (Conflict & Health, TB and Health Care Evaluation) and a MSc Project Report.  The topic of my master’s thesis deals with ‘Access to Opioids for Medical Purpose’ in the region that I am familiar with: Eastern Europe and Central Asia. Because of the fact that repression of recreational drug use is more the rule than the exception in that part of the world, access to psychoactive pain relieving chemicals is seriously hindered and not considered from a public health perspective. Patients in need and pain unnecessarily suffer from repressive policies, strict legislation and control measures.

In western countries, access to opioids is well regulated and monitored and both physicians and their patients have a large choice of forms to administer narcotic substances, be it intravenous, oral, through transdermal patches or by using lollipops and lozenges for those who can’t swallow properly.  In January 2015  I have been offered the unique opportunity of a three-week internship as a palliative care nurse at a comprehensive cancer center in Brooklyn, N.Y. and together with the palliative care team I will be able to learn first-hand how pain management is working in practice and how access to opioids is regulated through the lens of public health need.  Being in the U.S., I might also be tempted to sit for the NCLEX (pronounce ‘enkleks’), which is a computer-adaptive test (CAT) to become a licensed practical nurse (LPN) or a registered nurse (RN) in the United States.  That is, if the Commission on Graduates of Foreign Nursing Schools will positively assess the authenticity of my Georgian nursing degree. This CAT test is not a sinecure but a five hour multiple-choice examination consisting of minimum 85 and maximum 205 questions (correct answers lead each time to harder questions). The topics range from health promotion to infection control, coordinated care and safety, psychosocial integrity, physiological adaptation, reduction of risk potential and pharmacological therapies. Judging from this list I am afraid I would need quite some preparation and even if the starting median annual salary for an LPN (or RN) is over 40,000 US$ (60,000 for RN) I prefer to save time and pass my three last LSHTM exams and write a decent summer project!

I am linking to a remarkable video clip of the Global Commission on Drug Policy: a three minute fairytale illustrating what repression does to drug use: https://www.youtube.com/watch?v=csnTAz0Sth8

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