May 01, 2026
In his Hindustan Times column, Vital Signs, OHT’s Dr. Ramanan Laxminarayan describes a dual opioid crisis, too little access for patients who need pain relief, and rising misuse elsewhere.
India is one of the world’s largest producers of legal opium, yet very few patients, especially those with cancer, receive adequate pain relief. He explains that this imbalance has deep roots. During colonial rule, opium in India was tightly controlled for export and revenue, not for local medical use. These restrictions carried over into modern laws, making it difficult for doctors to prescribe medicines such as morphine, a type of opiate painkiller. As a result, many patients, especially those with cancer, still suffer without adequate pain care.
At the same time, weaker regulations around drugs such as tramadol have led to misuse in some regions.
Dr. Laxminarayan suggests separating medical use from illicit control, improving doctor training, reducing stigma around opioids for pain relief, and ensuring patients get the care they need while limiting abuse. “The challenge for India is to simultaneously widen the medical pathway for appropriate use, and police the illicit one. Those are not the same problem and do not have the same solution.”
Read it here.
