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Cancer pain management in Mexico
  1. Sarah Barry Lincoln1,
  2. Enrique Soto-Perez-de-Celis2,
  3. Yanin Chavarri-Guerra3,
  4. Alfredo Covarrubias-Gomez4,
  5. Mariana Navarro5 and
  6. Paul E Goss6,7
  1. 1Global Cancer Institute, Boston, Massachusetts, USA
  2. 2Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico
  3. 3Department of Hemato-Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico
  4. 4Department of Pain and Palliative Medicine, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico
  5. 5Universidad Nacional Autónoma de México, Coyoacan, Mexico
  6. 6Massachusetts General Hospital, Boston, Massachusetts, USA
  7. 7Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Sarah Barry Lincoln, Global Cancer Institute, Boston, MA 02114, USA; slincoln{at}globalcancerinstitute.org

Abstract

Background Pain control is an essential component of high-quality palliative care. Unfortunately, many low-income and middle-income countries lack an appropriate infrastructure to provide palliative care and suffer from a severe lack of access to opioid analgesics to alleviate pain from various conditions such as cancer.

Objectives We aimed to review the history and current status of cancer pain management in Mexico, a middle-income Latin American country. Our objective was to identify existing barriers to proper, effective opioid use, as well as provide practical recommendations for improvement.

Methods Using a search of EBSCOhost database, PubMed and Google, we found official documents and peer-reviewed articles related to health legislation, opioid consumption, palliative care infrastructure and palliative care training in Mexico.

Results Despite advances in palliative care and access to opioids in Mexico, there are still several barriers that undermine effective pain management, showing a major gap between policy and practice. Although Mexican legislation and guidelines include adequate palliative care and pain control as a right for all patients with cancer, the lack of adequate infrastructure and trained personnel severely hampers the implementation of these policies. Additionally, there are important barriers to prescribing opioids, many of which are related to attempts at reducing the consumption of recreational drugs.

Conclusions Although Mexico has made significant improvements in pain control and palliative care, much needs to be done. Expansion of drug availability, improvement of palliative care training, and constant oversight of regulations and guidelines will help to strengthen Mexico’s palliative care services.

  • cancer
  • pain
  • palliative care
  • opioid analgesics
  • developing countries
  • Mexico
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Footnotes

  • Contributors Conception and design: SBL, ESPdC. Collection and assembly of data: SBL, ESPdC, YCG, ACG, MN. Manuscript writing: all authors. Final approval of the manuscript: all authors. Accountable for all aspects of the work: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests YCG reports grants from Roche, outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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