Do International Model Drug Control Laws Provide for Drug Availability?

Abstract

A preliminary review of the United Nations Office on Drugs and Crime (UNODC) model drug control laws was conducted by the Pain & Policy Studies Group (PPSG) to determine whether the models provided governments with language they can use to carry out the obligation to ensure adequate availability of opioid analgesics for the relief of pain and suffering, specified in the Single Convention on Narcotic Drugs, 1961 as amended, and as recommended by the International Narcotics Control Board in 1995. The results showed that current model laws lack the drug availability provisions. Based on initial positive feedback from the International Narcotics Control Board, the UNODC, and the World Health Organization, the PPSG developed preliminary recommendations based on existing provisions in the Single Convention. The PPSG's main recommendation is that updated model laws are needed and that consideration should be given as to how to achieve this objective. The assessment is offered as a starting point for discussion. The World Health Organization (WHO) considers opioid analgesics to be essential for the treatment of pain, but there are great disparities in their availability among countries of the world, leading to needless pain and suffering. Over a period of 15 years of study and efforts to rectify these disparities, the PPSG has found that national narcotics control laws often do not contain provisions that recognize the dual obligation of governments under the international drug control conventions not only to control narcotic drugs but also to make them adequately available for medical and scientific purposes. International drug control organizations develop and publish model narcotics laws and regulations for governments to use. If these models convey the dual obligations of governments, the models would be considered “balanced,” and national governments would have model policy language not only for control of licit drugs, but also for their availability. Most governments have already adopted laws to implement the Single Convention; however, it is not known if they followed the Single Convention itself or model laws. The PPSG conducted this preliminary assessment of whether the models published by the United Nations Office on Drugs and Crime are balanced, using as a guide the 1995 recommendations of the International Narcotics Control Board (www.incb.org/pdf/e/ar/1995/suppl1en.pdf) and the 2000 WHO publication Achieving Balance in National Opioids Control Policies: Guidelines for Assessment (www.painpolicy.wisc.edu/publicat/00whoabi/00whoabi.htm).

KEYWORDS:

• Analgesics controlled substances
• barriers
• control
• drug
• essential medicines
• international
• law
• opioid
• pain
• policy
• regulation

Notes

ⁱ In a 1995 INCB survey of governments, only 48% of responding governments reported that their laws recognize that narcotic drugs are indispensable for the relief of pain and suffering.

ⁱⁱThe INCB survey found that only 63% of responding governments said there was a provision in national policy regarding the obligation to ensure availability of narcotic drugs for medical purposes.

ⁱⁱⁱSee INCB Technical Report for Narcotic Drugs http://www.incb.org/incb/narcotic_drugs_reports.html

^ivThe INCB survey showed that 47% of responding governments identified health professionals' fear of legal sanctions as an impediment to opioid availability.

^vThe INCB survey showed that 59% of responding governments said they had not examined their methods for assessing medical need for opioids.

^ivA “Model Law for the application of the Single Convention on Narcotic Drugs, 1961” from 1969, although not considered to be current, was reviewed; no drug availability provisions were found.

The UNODC does publish a “check list” of the Main Mandatory Requirements on Parties which includes establishing a “special licit drug regulatory administration.” See United Nations Office on Drugs and Crime. UN Drug Control Conventions Checklist: Main Mandatory Requirements on Parties. Vienna, Austria: United Nation Office on Drugs and Crime; 2002. Available at http://www.unodc.org/pdf/lap_checklist_convention.pdf

^viiiThe reporting requirements listed here are abbreviated to include only those regarding the estimate of medical and scientific needs and consumption; to be complete, the other reporting requirements should be added during the drafting of new model policies.

^ixComplete analysis of international and national policy with respect to drug availability should include other conventions as well as other legitimate medical purposes for drugs (in addition to pain treatment).