I run OPIS, a think-and-do tank I founded that’s dedicated to the prevention of intense suffering of all sentient beings. We’ve been focused on improving access to controlled substances (morphine and psychedelics) for the effective treatment of severe pain (terminal cancer and cluster headaches, respectively) and, to a lesser extent through postings and talks, on ending factory farming. Our larger goal and where we are putting more of our efforts is in promoting compassionate ethics in governmental decision-making to prioritise the prevention of intense suffering. I’m the author of two books on ethics, The Battle for Compassion: Ethics in an Apathetic Universe (2011) and my new book, The Tango of Ethics: Intuition, Rationality and the Prevention of Suffering (January 2023). I’ve also co-organised a workshop in the Swiss Alps for suffering-focused EAs from around Europe. I’m officially based in Switzerland but spend much of my time in Greece. My background is in molecular biological research.
jonleighton
As you know, Lee, your post increased our interest (OPIS; http://www.preventsuffering.org) in this issue as a potentially tractable cause area, and after the Lancet Commission report a year ago, we became engaged with the issue through our UN Human Rights Council event and advocacy (http://www.preventsuffering.org/pain/). We have since been contacted by palliative care associations about collaborating, and so I prepared a document with some new thoughts and an analysis of promoting morphine access as a potentially cost-effective EA cause area for those interested in relieving some of the worst human suffering. The document is here: http://www.preventsuffering.org/wp-content/uploads/2018/10/Relieving-extreme-physical-pain-in-humans-–-an-opportunity-for-effective-funding.pdf I will also create a new EA Forum post to elicit feedback.
Yes, sure. For patients in the end stages of terminal diseases such as cancer or inadequately treated AIDS who are in severe pain, dependence is clearly not an issue. For others, short-term treatment with opioids has been shown in studies to lead to dependence in only a small fraction of cases. And for those with chronic pain, dependence on medication is arguably much less of a concern than for them to suffer.
The opioid crisis in the US and the irrational response by the authorities to drastically limit opioid prescriptions have been devastating to chronic pain patients, often suddenly deprived of a medication they have used stably for years that allowed them to function. It has also created the false impression that prescribing opioids to patients in need is a significant cause of drug deaths. Although overprescribing of pain medications in the past likely contributed to overuse and dependence, most of the overdoses today are due to street heroin and illegally imported fentanyl, a powerful drug which is also used to lace heroin.
There are also means to limit the risk of prescribed morphine getting into the wrong hands, such as distributing it in diluted oral form, which is of much less use to those with drug dependence—this has been done successfully in Uganda. So although opioids need to be managed carefully and precautions taken so that only those who need it can obtain it, there is ample evidence for how morphine can be provided to patients in need without reasonable grounds for opiophobia.
16 Oct: This short article sums up the irrationality of opiophobia: https://www.cato.org/publications/commentary/opioid-crisis-not-helped-panic