Comment author: vollmer  (EA Profile) 14 October 2018 10:38:03AM 0 points [-]

What would be the next steps funders could take if they would like to support this type of work?

Comment author: jonleighton  (EA Profile) 14 October 2018 07:27:24PM 0 points [-]

I would urge them to contact me to have a conversation about the specific ways we would use funding in support of local efforts.

Comment author: Sanjay 13 October 2018 04:36:10PM 2 points [-]

Really interesting piece, thank you. Could you please expand on the claim that fears about morphine dependence and misuse are unwarranted?

Comment author: jonleighton  (EA Profile) 14 October 2018 07:14:57PM 0 points [-]

Yes, sure. For patients in the end stages of terminal diseases such as cancer or AIDS who are in severe pain, dependence is clearly not an issue. For others, short-term treatment with opioids has been shown in studies to lead to dependence in only a small fraction of cases. And for those with chronic pain, dependence on medication is arguably much less of a concern than for them to suffer.

The opioid crisis in the US and the irrational response by the authorities to drastically limit opioid prescriptions have been devastating to chronic pain patients, often suddenly deprived of a medication they have used stably for years that allowed them to function. It has also created the false impression that prescribing opioids to patients in need is a significant cause of drug deaths. Although overprescribing of pain medications in the past likely contributed to overuse and dependence, most of the overdoses today are due to street heroin and illegally imported fentanyl, a powerful drug which is also used to lace heroin.

There are also means to limit the risk of prescribed morphine getting into the wrong hands, such as distributing it in diluted oral form, which is of much less use to those with drug dependence - this has been done successfully in Uganda. So although opioids need to be managed carefully and precautions taken so that only those who need it can obtain it, there is ample evidence for how morphine can be provided to patients in need without reasonable grounds for opiophobia.

Comment author: jonleighton  (EA Profile) 09 October 2018 12:03:05PM *  5 points [-]

As you know, Lee, your post increased our interest (OPIS; http://www.preventsuffering.org) in this issue as a potentially tractable cause area, and after the Lancet Commission report a year ago, we became engaged with the issue through our UN Human Rights Council event and advocacy (http://www.preventsuffering.org/pain/). We have since been contacted by palliative care associations about collaborating, and so I prepared a document with some new thoughts and an analysis of promoting morphine access as a potentially cost-effective EA cause area for those interested in relieving some of the worst human suffering. The document is here: http://www.preventsuffering.org/wp-content/uploads/2018/10/Relieving-extreme-physical-pain-in-humans-–-an-opportunity-for-effective-funding.pdf I will also create a new EA Forum post to elicit feedback.