KOCHI: Coping with pain is not easy, but her spirit is strong. Nafeesa (name changed), a widow in Pattambi, is battling advanced stage cancer. Her only medication is a morphine tablet, a pain reliever. Her aged brother travels all the way to the Regional Cancer Centre in Thiruvananthapuram to avail the medicine at a cheaper rate. But the catch is, doctors used to give tablets for a month earlier. Nowadays, they account for only 15 days. Unable to witness her brother’s struggle, the hapless woman is forced to reduce the frequency of medication.
Nafeesa’s is not an isolated case. Ever since the Drugs Controls Department imposed restrictions on the distribution of morphine tablets, thousands of cancer patients in the north and central Kerala are suffering due to the non-availability of the drug.
Stifled by the expensive treatment, they travel to the capital city every fortnight to get the medicine.
Among the reasons cited for their travails is the new directive on the sale of pain relievers and sedatives falling under the ND 3 category.
On April 1, the state drug controller had issued an order taking away the right from Assistant Drugs Controllers to issue permits to hospitals to purchase morphine and fentanyl citrate, a move aimed at curbing the dispensing of irrational quantities of narcotic drugs.
Only 180 Recognised Medical Institutions (RMIs) in the state are provided with the
licence to purchase these drugs. According to Drugs Controller Ravi S Menon, there was no uniformity in the dispensing quantity among these RMIs.
“AS there were allegations of misuse, abuse and diversion of the drug, we decided to monitor and ensure discretionary use of these drugs,” he said.
Pattambi MLA Mohammed Muhassin, who had raised the issue in the Assembly recently, told Express the order was doing more harm than good.
“There are many cancer patients living in palliative care centres in Pattambi. They get morphine tablets from Regional Cancer Centre around `15 cheaper than the market rate. But the Drugs Controller has imposed some restrictions on the distribution of the medicine, putting patients to hardship,” said Muhassin.
“Patients in the Malabar region are made to travel all the way to Thiruvananthapuram frequently to get adequate quantities of medicine,” he added.
Medicine shortage
There are around 500 palliative care units in the state and most patients seeking treatment at these units belong to the marginalised sections of society.
While patients complain they are unable to get sufficient quantity of morphine, hospitals allege they experience shortage of sedatives.
The representative of a super speciality hospital in Kochi said: “Earlier, we used to get permit from the Assistant Drugs Controller and purchased morphine and fentanyl citrate from Delhi. Now, we have to travel to Thiruvananthapuram to get the permit. We have to purchase drugs from a local distributor, whose rate is exorbitant. On a particular day, we had only five vials of morphine left and had three patients waiting for surgery. Later, we had to approach the minister’s office.”
A doctor at a multispeciality hospital in Kochi said they incur a loss of around `1.5 lakh per annum as they have to procure the medicine from a local distributor.
“Besides, we don’t get adequate quantity of quality medicine. The patients complain they are not getting relief from the fentanyl citrate patches provided by the local agency,” the doctor said.
Left in the lurch
On April 1, the right of Assistant Drugs Controllers to issue permits to hospitals to purchase morphine and fentanyl citrate was taken away
Only 180 Recognised Medical Institutions in the state are given licence to purchase drugs