Any discussion of ways to address the current opioid epidemic must also focus some attention on solutions to ensure/increase access in LMICs.
Currently 150 countries don't have routine access to morphine and the vast majority of opiates are consumed by a minority of the world's population in HICs. To date, most effort has been put into preventing abuse with relatively little energy put toward increasing access in LMICs. Although simultaneously ensuring these two goals was the dual purpose of the UN Single Convention, in many ways it has failed. As we discuss ways to prevent abuse we must carefully evaluate if any solutions impact access to opiates to patients in LMICs and also actively discuss ways to improve pain care outside HICs.