Estimation of Annual Need, Production and Per Capita Consumptions of Oral Morphine in Bangladesh

Fazle Noor  Biswas; Monira  Parveen; Md. Mostafa  Kamal; Megan  Doherty; Syed Ariful  Islam; Mridul  Sarker; Nezamuddin  Ahmad; A K M  Akhtaruzzaman

doi:10.62848/bjpain.v2i2.7711

Authors

Fazle Noor Biswas Clinical Pharmacist, Palliative, Care Center, BCS- My Care, Dhaka, Bangladesh. https://orcid.org/0000-0002-9456-4485
Monira Parveen Lecturer, Dept. of Pharmacology, Dhaka Dental College, Bangladesh
Md. Mostafa Kamal Anaesthesiologist, Department of Anaesthesia, Intensive Care and Pain Medicine, ShSMCH, Dhaka https://orcid.org/0000-0002-4665-1904
Megan Doherty Program Director, Children's Hospital of Eastern Ontario, Ottawa, Canada
Syed Ariful Islam Anesthesiologist, 250 Bed General Hospital, Brahmanbaria, Bangladesh
Mridul Sarker Coordinator, Dept. of Palliative Medicine, BSMMU
Nezamuddin Ahmad Founder Chairman & Retired Professor, Dept. of Palliative Medicine, BSMMU.
A K M Akhtaruzzaman Professor, Dept. of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU.

DOI:

https://doi.org/10.62848/bjpain.v2i2.7711

Keywords:

Oral Morphine, Annual Need, Annual Production, Per Capita Consumption, Bangladesh.

Abstract

Background: Worldwide, opioid analgesics prescribed for the management of moderate to severe pain in both malignant and non-malignant patients. Use of opioids for pain management is very limited in healthcare facilities of Bangladesh. For ensuring proper management this study aims to explore opioid consumption, accessibility and availability especially in cancer pain in Bangladesh.
Methods: This observational study used preconstructed questionnaire to estimate annual production and use of opioids at different settings. Information was obtained from annual drug report of 2020-2021 Bangladesh’s Department of Narcotics Control (DNC), Director General of Health Services of Bangladesh and three pharmaceutical companies. Availability and accessibility of morphine was explored among the tertiary care centre of Bangladesh using patient’s records
Results: Morphine and other 5 types of opioids are available in different formulations in Bangladesh. Locally only two pharmaceutical companies producing morphine though there are 3 are licensed. In last 5 years on an average 15.34 kg (range 10.9 kg – 20.1 kg) morphine produced. There are only a few hospitals where oral morphine is readily available. But almost all of them are metropolitan Dhaka based.
Conclusion: The low consumption of morphine indicates the poor pain management scenario of the country. Pain and palliative care professionals in Bangladesh continue to advocate for improvements which will ensure that opioids are available, accessible and affordable for all patients in Bangladesh.