Poor availability of oral morphine in Rajasthan pains cancer patients

Poor availability of oral morphine in Rajasthan pains cancer patients

Morphine, which provides relief from excruciating pain to terminal cancer patients, is in short supply in Rajasthan, like many other states, thanks to “tedious” procurement procedures and licensing norms for the drug, oncologists say.

Ironically, Rajasthan is only one of the three states in the country where opium poppy, from which morphine is extracted, is cultivated legally.

“Oral morphine is used for terminal patients of cancer across the world to relieve pain. But in India, only 4% of these patients get the drug,” said Dr Anjum Khan Joad, head of palliative care at Bhagwan Mahaveer Cancer Hospital and Research Centre (BMCHRC), Jaipur.

Oral morphine is a cost-effective painkiller; it costs just Rs. 1.10 per tablet while the injection costs anything between Rs. 11 and Rs. 20.

Dr Joad rued the poor availability of morphine tablets. “The procedure for procuring it is very long. One has to get five licences to obtain oral morphine,” she said, demanding that the state government make it easily available.

She raised the issue with the Rajasthan health minister recently when he visited BMCHRC, and the minister reportedly assured that he would make efforts to ensure it is easily available to terminal patients.

Oncologists also stress the need for training to doctors for its safe use. Though oral morphine given under a doctor’s supervision is not addictive, injections could be misused, Dr Joad said.

The Supreme Court, in August 2012, had directed chief secretaries of all states to ensure easy availability of morphine preparations for people in pain. But government sources say nothing has happened in Rajasthan so far.

According to an estimate, in India 70-80 people per lakh suffer from cancer. Dr Hemant Malhotra, head of oncology department, Sawai Man Singh Hospital, said, “Even we didn’t have it for last few years. The reason was lengthy paper work, a tedious process of procuring licences and unavailability of oral morphine. Just few months back, the hospital has started procuring oral morphine. Now, we have good stock and are giving it free of cost to terminal patients.”

Cancer expert and Rajasthan Cancer Foundation honorary chairman Dr Rakesh Gupta said oral morphine is available at only two or three hospitals in Rajasthan. He said the procedure has to be simplified to procure oral morphine and there has to be a single-window clearance.

“Myths related to morphine should also be cleared as it is seen as highly addictive. Medicinal morphine is safe and does not cause addiction,” he said.