Access to opioid analgesics for palliative care patients in Ukraine: Problems of past and present

Abstract

The results of research of the Ukrainian Palliative and Hospice Care League show that every year at least 600 thousand people with incurable illnesses (cancer, HIV/AIDS, diabetes, tuberculosis, and others) need palliative care. However, nowadays the realisation of the right to a dignified death for incurable patients is difficult because of numerous problems of legislative, organisational, technical, personnel, and moral-ethical nature. Therapy of chronic pain syndrome is a significant problem for palliative patients in Ukraine, who do not receive adequate analgesia. There is non-compliance with the World Health Organisation recommendations for pain relief, a strict and complicated legal framework for narcotic medicines and licensing of health care facilities (and the reluctance of such establishments to obtain a license), collisions with prescribing of opioids, fear of doctors to prescribe high doses of analgesics for patients, and the lack of appropriate skills and experience in the treatment of chronic pain in medical specialists. That is why the access of patients to analgesic drugs is limited. However, despite the numerous problems, since 2013 there have been positive changes, in particular, on the writing of prescriptions for opioids for palliative care patients.