Saint Joseph's University, 5600 City Avenue, Philadelphia, Pennsylvania 19131, USA.
Med Sci Monit. 2010 Mar;16(3):RA49-57.
The World Health Organization has reported that somewhere between 30-86 million people suffer from moderate to severe pain due to cancer, HIV/AIDS, burns, wounds and other illnesses annually and do not have access to proper opiate anesthetics to control the pain [1]. The vast majority of these people live in poor nations where medicinal opiates are either too expensive or not readily available. In this paper, it is argued that access to adequate healthcare is a human right and that adequate healthcare includes management of pain. The solution to this problem may be in Afghanistan, a country now overwhelmed with poverty and war. Afghanistan is the world's leading producer of heroin. The increase in heroin production in Afghanistan has caused the United States and the international community to begin to eradicate Afghanistan's poppy fields leading to increased poverty among poppy farmers. This paper proposed a paradigm that can be implemented in Afghanistan which would allow for Afghan farmers to continue growing their poppy crop for medicinal opiates like morphine for poor nations. The paradigm covers all parameters of medicinal opiates production including licensing, security, cultivation, harvest, and factory production of medicinal opiates. The paradigm proposed is less expensive than eradication, brings honest income to Afghan farmers and the new Afghan nation, and can eventually lead to Afghanistan acquiring a respectable role in the world community. In closing, a full ethical analysis of the paradigm is included to justify the arguments made in the paper.
世界卫生组织报告称，每年有 3000 万至 8600 万人因癌症、艾滋病、烧伤、创伤和其他疾病而遭受中重度疼痛，但他们无法获得适当的阿片类麻醉剂来控制疼痛[1]。这些人绝大多数生活在贫困国家，那里的药用阿片类药物要么过于昂贵，要么难以获得。本文认为，获得足够的医疗保健是一项人权，而足够的医疗保健包括疼痛管理。解决这个问题的办法可能在阿富汗，这个国家现在正被贫困和战争所淹没。阿富汗是世界上最大的海洛因生产国。阿富汗海洛因产量的增加导致美国和国际社会开始铲除阿富汗的罂粟田，导致罂粟种植者贫困加剧。本文提出了一个可以在阿富汗实施的模式，允许阿富汗农民继续种植罂粟，用于生产吗啡等药用阿片类药物，以供应贫困国家。该模式涵盖了药用阿片类药物生产的所有参数，包括许可、安全、种植、收获和药用阿片类药物的工厂生产。所提出的模式比铲除成本更低，为阿富汗农民和新的阿富汗国家带来了诚实的收入，并最终使阿富汗在国际社会中获得一个受人尊敬的角色。最后，本文对该模式进行了全面的伦理分析，以证明本文中提出的论点。
