Russia’s Federal Drug Control Service says doctors must “increase access” to pain relief medicine for seriously ill patients, following the death of a high-profile admiral who shot himself after being denied morphine in the end-stages of cancer.
The drug control service “has never been against the use of
painkillers,” it said in a statement.
“Although federally, we have liberalized legislation, local
authorities still have not remodeled their system to increase
patient access to pain relief medicine.”
The defensive statement has been prompted by a public outcry over
the painful death of 66-year-old retired Admiral Vyacheslav
Apanasenko, who was once responsible for Russia’s underwater
ballistic missile arsenal.
According to his daughter, last Friday, Apanasenko’s wife did not
make her way through the assorted waiting lines before a Moscow
clinic shut for the weekend, leaving her one signature short and
without the prescription. Facing the prospect of suffering
through several days of intolerable pain, Apanasenko took out his
service pistol and shot himself in the head.
But the shot was not lethal, and the retired admiral was taken to
hospital with severe head injuries, where he died three days
later.
His daughter told the media he had been upset, and that the
denial of medicines was “the final straw.”
“I am prepared to suffer, but to see the suffering of those
close to me is an unbearable pain,” Apanasenko apparently
wrote in a suicide note.
His story is not a one-off.
Prior to last year, Russia had one of the world’s most
restrictive prescription protocols for analgesics, with both
doctors and patients risking potential accusations of illegal
drug possession and distribution every step of the way.
Doctors had to receive approval from their head of department for
every single prescription. Only one type of painkiller could be
included in it, and anything but the smallest doses could arouse
suspicion from the Federal Drug Control Service. Those suffering
from chronic but non-terminal conditions were not routinely given
any painkillers at all.
In turn, patients had to hand back every used vial of
painkillers, as well as to receive a new assessment for every
extension. In numerous cases even those with late-stage terminal
illnesses had to personally show up at the hospital at regular
intervals. In rural areas, this could necessitate trips of dozens
of kilometers.
It is estimated that, on average, patients receive at least 10
times as many painkillers in the West as in Russia.
The Federal Drug Control Service officially relaxed the
legislation last year, but anecdotal stories from patients and
doctors suggest that the situation has not changed.
Among the roadblocks are pieces of local legislation that do not
align with federal laws, physicians who are still scared of drug
officials and a medical culture that views analgesics as a last
resort.
“In any country the provision of sufficient painkillers for
the duration of the illness is a fundamental part of
healthcare,” Yuri Zhulev, who heads Russia’s patients
association, told Rossiyskaya Gazeta newspaper.
“From the perspective of the drug authorities, there may well
be a risk of these medicines ending up on the black market. But
these fears are not an excuse to torture sick people and their
relatives.”