Tamil Nadu is facing acute shortage of morphine, a drug mainly required for pain management in cancer patients. This is despite the amendment of Tamil Nadu Narcotic Drug Rules 1985 in December 2000, for making the availability of morphine to the patients with less restrictions.
With the amendment, it was believed that morphine would be available at select registered institutions, registration being done with the Drug Control Administration (DCA), Tamil Nadu. The rules were amended in a record time of eight months.
The DCA identified three hospitals, Cancer Institute and Apollo Speciality Hospital; both Chennai and G.Kuppuswamy Naidu Hospital, Coimbatore. Along with these three hospitals, two other institutions in Chennai namely, Jeevodhaya and Dean Foundation were also given the tag of registered institutes where morphine could be obtained.
But these three institutions are themselves facing short supply of morphine. To compound the problem further, the DCA is still to renew the licences of the two hospices whose registration expired in March 2002. Moreover, the registration of the three hospitals too is due to expire. Though all of them have submitted the necessary papers with the DCA, they still have to get the registration in hand. As a result, stocking of morphine at their premises is becoming difficult. The Cancer Institute is bearing the brunt of the restricted morphine supply as most patients are directed to it, it being a regional centre.
The Cancer Institute has had free morphine supply from the World Health Organisation (WHO) which has stocked morphine stock in Cancer Institute, Kolkatta worth Rs one crore. However, sources in the Cancer Institute claim the stock would only last till March 2004 given the unprecedented rush to access morphine.
What further adds to the agony of the patients is the price at which morphine is being sold. The buyers are forced to pay 20 per cent excise duty, eight per cent sales tax plus a 15 per cent additional sales tax to companies in other states. Thus making the drug more expensive. Terminally ill patients need it the drug at frequent intervals and the high price only adds to their woes.
The state currently takes two kgs of raw morphine from the Narcotics Bureau but medical experts claim the requirement is actually around 10 kgs. Experts claim the requirement of morphine at the Cancer Institute itself touches 5 kgs. The only pharmaceutical manufacturer in the state manufacturing morphine is Tablets India Ltd. It supplies one-fifth of the total requirement. Two things work against Tablets India Ltd and the patients too. While Tablets India makes morphine in injectable form, most patients prefer morphine in the oral form. Tablets India sources claim they are ready to manufacture morphine in the oral form only if they get the necessary orders from the DCA. But the orders have still not come to it inspite of the matter being brought to the notice of the DCA.
Pharmaceutical manufacturers come in the way of more supply of morphine. They are unwilling to manufacture the drug given the stringent rules stipulated by the Narcotic Drug Rules and the bureaucratic delays in obtaining the drug licence and raw morphine. No rules have been amended to make things easier for the pharmaceutical companies to acquire raw morphine. For them it is tedious to give account of every gram of raw morphine they procure.