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The British Journal of Psychiatry (2003) 183: 15-21
© 2003 The Royal College of Psychiatrists

REVIEW ARTICLE

Pain, anxiety and insomnia – a global perspective on the relief of suffering

Comparative review*

HAMID GHODSE, FRCPsych

International Centre for Addiction Studies, Department of Addictive Behaviour and Psychological Medicine, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK

Declaration of interest None.

* Originally presented as the Maudsley Lecture, 24 July 2002, Cardiff.

Background The unavailability of psychotropic and analgesic drugs for medical purposes results in suffering that goes unrelieved. Their excessive availability results in overmedication and suffering of a different kind.

Aims To highlight the discrepancies between the demand for and supply of controlled drugs for licit purposes by different communities, and to promote their rational utilisation.

Method Review of the United Nations, World Health Organization and other literature on the licit use of narcotic analgesics and psychotropic substances.

Results There are large differences in the use of psychotropics and analgesics by different countries. The differences between industrialised and non-industrialised countries are particularly striking. There is evidence of unmet need in some countries and overutilisation in others.

Conclusions Governments, international organisations, health professionals and the pharmaceutical industry must work together to ensure an adequate supply of psychotropic and analgesic drugs for medical and scientific purposes, and to implement appropriate measures to minimise the development of misuse and dependence.




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