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Last month, an Egyptian court sentenced Laura Plummer, a 33-year- old English shop worker, to three years in prison for smuggling 320 doses of Tramadol into the country.Last October, the Lancet Commission on Palliative Care and Pain Relief issued an impressive 64-page report arguing that relieving severe pain is a "global health and equity imperative". Each year 25.5 million people die in agony for lack of morphine or a similarly strong painkiller.Citizens of affluent countries are used to hearing that opioids are too easy to get.In the United States, the quantity of available opioids – that is, drugs with morphinelike effects on pain – is more than three times what patients in need of palliative care require. People in the U.S. suffer from overprescription of opioids while people in developing countries are often suffering because of underprescription.The total cost of closing the "pain gap" and providing all the necessary opioids would be just $145 million a year at the lowest retail prices (unfairly, opioids are often more expensive for poorer countries than richer ones).Designing a system that provides adequate access to morphine without encouraging overprescription or leaking drugs onto the black market is tricky but not impossible.
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