Because drug abuse and inadequate treatment of intractable pain are international health problems, international treaties have been established to pose as models for nations to develop their own laws stipulating the need for opioid pain treatment while controlling drug diversion.

The most important international treaty regulating narcotic drugs is the 1961 Single Convention. This treaty was formed to decrease international drug abuse and increase support for opioid use in pain treatment.³ The preamble states that "the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering and that adequate provision must be made to ensure the availability of narcotic drugs for such purposes." ⁴

Commentary on the 1961 Single Convention, written by the Secretary-General of the United Nations, suggested that prescription drugs be placed into different categories or schedules, according to abuse and therapeutic potential, to aid in drug regulation.

Also, the Secretary-General stated that healthcare providers should not be required to track each individual acquisition and disposal of a controlled drug, and pharmacists should not be obligated to record each sale as both instances may pose a burden on effectively ensuring availability of opioids for pain treatment.⁵

You will find in the state laws and regulations section below that state laws do not follow this international treaty as most require both physicians and pharmacists to track each opioid prescription while the state monitors their prescribing patterns. State laws place these restrictions on opioids to monitor for physicians who may be selling opioid prescriptions to drug abusers. Unfortunately, these restrictions tend to limit the amount of opioids physicians are able to prescribe for intractable pain. As a result, healthcare providers do not prescribe adequate amounts of opioids to relieve intractable pain for fear of regulatory scrutiny.^2,6,7