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II. Obligations arising from human rights standards

1.3 Access to controlled substances as medicines

Access to controlled medicines without discrimination is a key element of the right to health. This includes for use as opioid substitution therapy, for pain management, in palliative care, as anaesthesia during medical procedures, and for the treatment and management of various health conditions.

In accordance with their right to health obligations, States should:

i. Take legal and administrative steps to ensure the adequate availability, accessibility, and affordability of controlled medicines, with a particular focus on those medicines included in the World Health Organization Model List of Essential Medicines.

ii. Amend laws, policies, and regulations that unnecessarily restrict the availability of and access to controlled medicines.

iii. Follow the procedures established in the international drug control conventions when scheduling a substance that has medical uses, and balance the substance’s public health risks with the effects of scheduling on restricting the availability, accessibility, and affordability of medications containing the substance.

iv. Include access to controlled essential medicines for drug dependence treatment, treatment of pain, and palliative care in national health plans and policies and on national essential medicines lists.

v. Ensure the special provision of controlled medicines for children, including appropriate paediatric formulations of such medicines.

vi. Introduce health service provider training on drug dependence treatment, palliative care and pain management, and other medical conditions that require the use of controlled drugs for medical purposes, and integrate training regarding stigma, discrimination, and respect for patients’ rights (including the equal rights of patients who use drugs) into ongoing health workforce education and training.

vii. Raise public awareness about the right to have access to controlled drugs for medical purposes, including for the treatment of drug dependence and pain relief, and about the availability of such treatment.

viii. Consider reviewing the 1961 and 1971 drug control conventions’ schedules of substances under international control in light of recent scientific evidence, and prioritise exploring the medical benefits of controlled substances in accordance with the World Health Organization’s scheduling recommendations.


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