This study aimed to explore current opioid availability and accessibility for palliative care (PC) practice in Nepal. A narrative review was conducted by performing literature searches in electronic databases, grey literature, policy documents, and pharmaceutical websites. This was supplemented by utilising the authors' expertise and experience in this field. Six different opioids are available in Nepal, including oral immediate and modified-release morphine formulations. Morphine is produced and distributed by only one manufacturer, which imports all raw materials from Europe. Access to morphine in rural areas is poor, with rural-level healthcare centres rarely stocking morphine, particularly in PC formulations. Fentanyl transdermal (TD) patch and methadone syrup are available in Nepal but are imported. The Fentanyl TD patch is extremely expensive, and methadone syrup is only available for the management of addiction. While opioid availability has increased in Nepal, there is a need to improve opioid accessibility for PC services, particularly in rural areas. Several approaches are explored in this review.
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http://dx.doi.org/10.25259/IJPC_118_2024 | DOI Listing |
Int J Drug Policy
March 2025
University of Washington Medicine, Department of Psychiatry & Behavioral Sciences, Addictions, Drug & Alcohol Institute, Seattle, WA, USA. Electronic address:
Background: The opioid epidemic presses on as a significant public health issue in the U.S., with particularly high overdose death rates in the Southeast.
View Article and Find Full Text PDFCan J Public Health
March 2025
Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
Setting: This paper describes the Safer Opioid Supply (SOS) program, a public health intervention in London, Ontario, in response to the toxic unregulated drug supply which is driving the overdose crisis in Canada.
Intervention: The London InterCommunity Health Centre (LIHC) SOS program provides comprehensive harm reduction and primary health care services to individuals at risk of overdose from the toxic drug supply. Clients are prescribed high-dose pharmaceutical opioids as replacement for unregulated toxic substances within a low-barrier primary care clinic, with wraparound interdisciplinary social services, embedded in the Ontario Community Health Centre model of care.
Med Care
March 2025
New York State Office of Addiction Services and Supports, New York, NY.
Background: Opioid agonist treatments (OAT; methadone and buprenorphine) for opioid use disorder (OUD) reduce overdose death by more than 50%. Low population-level rates of OAT are missed opportunities to reduce OUD-related mortality.
Objective: We examined county-level OAT utilization patterns to guide state-level and county-level initiatives to improve equitable access and utilization in New York State (NYS).
J Opioid Manag
March 2025
Department of Surgery, Baylor University Medical Center, Dallas, Texas.
Background: The United States (US) is facing an opioid epidemic. Prescribed opioids are a contributor to this national issue. Strategies to reduce opioid prescriptions are a high priority.
View Article and Find Full Text PDFAddict Sci Clin Pract
March 2025
The Substance Use Disorder Solutions Network, Wilmington, United States.
Background: Translating innovative research advancements into commercially viable medical interventions presents well-known challenges. However, there is limited understanding of how specific patient, clinical, social, and legal complexities have further complicated and delayed the development of new and effective interventions for Opioid Use Disorder (OUD). We present the following case studies to provide introductory clinical, social, and business insights for researchers, medical professionals, and entrepreneurs who are considering or are currently developing medical.
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