All of us with chronic pain have many significant obstacles to getting better, including:

• our diseases themselves, some of which aren’t “curable”
• finding physicians who understand pain and can help us
• tolerating medication – sometimes when medication does help, the side effects are pretty bad
• trying to arrange insurance coverage for appropriate treatment

Now, imagine having chronic pain while living in Rwanda or Afghanistan…

In places like these, even if you had a disease which was curable, there might be no medical treatment – no doctor, no physical therapist, no labs.  You might not have any extra money for available treatment.  And the medications that can help manage pain might not be available, or might not be affordable.

An article by Donald G. McNeil, Jr. in The New York Times (10/14/07) cites a WHO estimate that over 6.2 million poor people with cancer, AIDS, burns or wounds don’t get adequate pain relief.

One novel idea coming out of Britain proposes buying Afghanistan’s poppy crop, which usually finds its way to become heroin, and instead, making morphine for the world’s poor.  Senlis Council, a drug-policy research group estimates that $600 million could buy the whole crop.  While this is a significant price, they counter that the US and Britain already spend $800 million trying to eradicate poppy production.  So why not get something helpful in return?

There are, of course, arguments against this, including that farmers will still sell to opium producers, as they pay more, and that poppies grown for morphine will still get diverted for illegal ends, so eradication is a safer way to go.

But this struck me as out-of-the-box thinking to address a difficult situation for people with pain who are unable to get appropriate treatment.  Poor pain care is also certainly part of the wider issue of generally poor health care for the world’s poor.  And while the DEA agent who finds a poppy crop in your garden probably won’t believe you were sending the white sap to Afghanistan, at least this idea of turning poppies into morphine may blossom into some possible ways to address the problem of undertreated pain.