As of today, thousands of cancer patients in Armenia may soon be able to get the pain treatment they need – and to which they have the right – thanks to new regulations the government adopted earlier in November.
About 8,000 people die from cancer in Armenia every year – many of them in excruciating pain, due to the nearly insurmountable bureaucracy around obtaining opioid pain medications.
When I learned of this change, I could not help but think of dozens of people I interviewed several years ago in Armenia, who described to me the devastating effects of untreated pain on their lives and the lives of their loved ones. Among those I interviewed was Gayane, a 46-year-old woman, who told me:
“The pains are unbearable; I cry, I scream, feel like I am walking on fire all the time. […] I try to endure the pain when someone is at home, but when I am alone, all I can do is cry. ... I live in pain all the time.”
Gayane’s experience was not exceptional. In July 2015, Human Rights Watch published a report showing the impact of untreated pain and lack of support services for cancer patients and their families in Armenia. Only oncologists could prescribe opioids to outpatients, and only after multiple doctors – who formed standing commissions – had signed off on the decision. Even then, patients needed multiple signatures and seals for each prescription, which had to be obtained and filled every day or every other day at a specialized pharmacy or large regional medical centers.
On November 9, the government overhauled these onerous procedures, in place since 1994, which made it practically impossible to access opioid pain medications. Earlier this year, the government also adopted a national strategy to introduce palliative care services, which focuses on pain relief and improving the quality of life. It also registered two forms of liquid oral morphine, paving the way for their use in the public healthcare system.
The new regulations also allow an oncologist or a family doctor to prescribe strong pain medication with the approval of a chief or a deputy chief doctor, and do so for a 10-day supply.
The new regulations are expected to go into force in about 10 days. With the right follow-up, these regulations will help ease the suffering of the terminally ill and their families who care for them.