Enablers and barriers to opioid access in Asia

About the project

Project title: Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: a systematic review, critical interpretative synthesis and development of a conceptual framework.
Time frame: Completed
Contact for more details: Dr Joseph Clark

Opioids are essential pain-killing medicines. Despite international and national laws permitting availability, opioid access remains inadequate. 

We conducted a systematic review of post-2000 research to explore the perceptions and experiences of regulatory enablers and barriers to opioid access in South, Southeast, East and Central Asia.

We found the following barriers to access:

  1. A lack of laws explicitly enabling opioid access, restrictive international controls and clinician prescribing concerns,
  2. Limited availability, poor policymaker and clinician education, interrupted supply,
  3. Medicine costs, distance to prescribing centres, and
  4. Extensive bureaucratic barriers, lack of human resources for prescribing.

There is a self-perpetuating model of inadequate opioid provision whereby inadequate consumption informs annual requirement estimates used to determine future opioid availability.