Restrictive narcotics laws and excessive regulation are denying pain relief to over a million terminally ill patients each year in Pakistan, national and international experts said, terming the situation an ethical and human rights failure that leaves thousands to die in agony without access to morphine and other modern pain-relief medicines.
Speaking at a session on ‘Equitable Access to Pain Management in Palliative Care in Pakistan’ during the 22nd Health Asia International Exhibition and Conferences in Karachi, experts warned that the country’s failure to ensure opioid access for medical use amounts to a public health emergency and a national failure of compassion.
“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 created a climate of overregulation. “We must separate medical need from criminal control. Denying morphine to a dying patient is not regulation, it is cruelty,” he said.
Prof. Dr. Shahzad Ali Khan, vice chancellor of the Health Services Academy, said pain relief was not charity but an ethical duty of the state. “Palliative care is a test of a country’s conscience,” he said, adding that the academy would soon launch diploma and certificate programmes in palliative care.
Dr. Waseem Gill, a UK-based health consultant 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.
From the National Institute of Health, 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 added.
Experts, including Dr. Samia Latif, a UK-based consultant in global health, said Pakistan’s current opioid control system is so restrictive that doctors often avoid prescribing pain medicine out of fear. “Relief from pain is not a luxury. It is about dignity, compassion, and human rights,” she 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. Junaid Patel from the 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.
A short film by Sara Iram Gill on the suffering of terminally ill patients moved the audience to tears. Senior health journalist M. Waqar Bhatti said the film captured a painful reality. “It is easier to buy heroin in Pakistan than morphine for a dying patient. This hypocrisy punishes the innocent while criminals thrive,” he said.
Speakers urged the Drug Regulatory Authority of Pakistan (DRAP) and the Health Ministry to reform outdated narcotics laws, simplify hospital procurement of opioids, 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 genuine 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.”