Pain and the struggle for relief: How fear influences patient access to medical opioids

Indonesia grapples with a severe shortage of medical opioids, despite the International Narcotics Control Board recognizing them as essential medicines. The country consumes only 26 opioid doses per million people per day, significantly lower than regional and global standards. The issue stems from the government's strict approach to narcotics, prioritizing potential harms over patients' clinical needs.

Indonesia's National Essential Medicines List includes several strong opioids, but their importation is limited due to concerns about misuse. Many hospitals face shortages and long procurement delays, leading some doctors to seek alternative pain management solutions. Government officials acknowledge the shortage is concerning, but some argue increased opioid supplies could lead to misuse, crime, and addiction, concerns fueled by the North American "opioid crisis."

Indonesia's situation differs significantly, with tighter controls on opioid imports and distribution, and opioids not prescribed for long-term pain management. Despite this, researchers found no evidence of inappropriate opioid prescribing. The 64 healthcare workers interviewed supported strict government oversight but also highlighted operational problems that hinder access.

Policymakers must differentiate between preventing illegal trafficking and ensuring access to pain relief, as both are crucial aspects of the right to health for Indonesian citizens.