Karachi: Over a million terminally ill people in Pakistan suffer unbearable pain every year as morphine and other essential pain medicines remain out of reach due to restrictive narcotics laws, excessive regulation, and official neglect, a crisis experts say amounts to a ‘national failure of compassion’ and a ‘violation’ of basic human rights.
Experts raised alarm over this crisis during a special session on Equitable Access to Pain Management in Palliative Care in Pakistan held at the 22nd Health Asia International Exhibition and Conferences in Karachi. They warned that Pakistan’s failure to ensure access to essential opioids for medical use amounts to a public health emergency and a violation of human rights.
“More than 80 percent of the global population has access to less than 20 percent of medical opioids, and Pakistan falls in that majority,” said Dr. Kamran Niaz, Senior Epidemiologist with the UN Office on Drugs and Crime (UNODC). “If we continue at the current pace, it could take developing countries like ours more than two centuries to reach even half the level of opioid access enjoyed by rich nations,” he cautioned.
Dr. Niaz said fears about misuse have led to excessive regulation, depriving genuine patients of relief. “We must separate medical need from criminal control. Denying morphine to a dying patient is not regulation, it is cruelty,” he said.
Chief guest and facilitator for the session Prof. Dr. Shahzad Ali Khan, Vice Chancellor of the Health Services Academy, called palliative care a test of a country’s conscience. “Pain relief is not charity, it is an ethical obligation of the state,” he said, announcing that the Academy would soon launch diploma and certificate courses in palliative care.
UK based health consultant Dr. Waseem Gill, who co chaired the session, shared how timely pain medication gave his cancer stricken wife a peaceful end. “My wife’s last days were calm because she had access to proper pain relief. That comfort and dignity should be available to every patient, not just the privileged,” he said.
Dr. Junaid Patel from Indus Hospital and Health Network called for introducing pain medicine and palliative care into all medical and nursing curricula. “Regulators and policymakers only act when their own families suffer. We must institutionalize compassion before it is too late,” he remarked.
From the National Institute of Health (NIH) Islamabad, Dr. Mumtaz Ali Khan urged the government to classify opioid painkillers as essential medicines, ensure responsible prescribing, and establish a National Palliative and Pain Medicine Centre. “We must build community based palliative care centres and bring pain management to the doorstep of every Pakistani,” he said.
Renowned psychiatrist Prof. Dr. Iqbal Afridi, Head of Psychiatry at Jinnah Postgraduate Medical Centre, said untreated pain leads to depression, anxiety, and suicidal thoughts. “When physical agony is ignored, it devastates mental health too. Pain management must include psychological care,” he said.
Dr. Samia Latif, a UK based consultant in global health and chair of the session, said relief from pain is not a luxury. It is about dignity. It is about compassion. It is a human right.
She said Pakistan’s current opioid control system is so restrictive that doctors avoid prescribing pain medicine out of fear. “We must create a system that trusts doctors and safeguards patients, not one that lets them suffer,” she stressed.
A short film by Sara Iram Gill on the suffering of terminally ill patients drew tears from the audience. Senior health journalist M. Waqar Bhatti said the film reflected a grim truth. “It is easier to buy heroin and methamphetamine in Pakistan than morphine for a dying patient. This hypocrisy is punishing the innocent while criminals thrive,” he said.
Speakers urged the Drug Regulatory Authority of Pakistan (DRAP) and the Health Ministry to reform historic narcotic control laws, simplify opioid procurement for hospitals, and integrate palliative care into the primary healthcare system. They praised DRAP CEO Dr. Obaidullah and Federal Health Minister Syed Mustafa Kamal for taking initial steps toward regulatory reform.
“There is a desire and intent to work together to overcome this issue and that is a good starting point,” the panel concluded. “Pain relief is a measure of humanity, and Pakistan has taken its first step toward ensuring dignity in suffering.”
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