Organizations involved in the provision of medical supplies in emergency situations are often faced with serious difficulties in providing narcotic and psychotropic medicines because of the regulatory requirements concerning their exportation and importation. The lack of these medicines results in additional human suffering by depriving those in need of adequate pain relief and sedation. This makes these medicines an essential part of medical supply in emergency situations.
The Basic Unit of the Interagency Emergency Health Kit 2006 does not contain any substances that are regarded as narcotics or psychotropics, so they are not under international control and will not require additional formalities for international transport.
However, the Supplementary Unit contains several substances under international control, and other substances in it are under discussion for future control. Also, certain countries have additional national regulations for medicines not under international control.
Substances from the Kit under international control are morphine injection 10mg/ml, 1 ml-ampoule; diazepam injection 5mg/ml, 2 ml-ampoule and phenobarbital tablets 100mg. Morphine requires import and export licences in any case. For the two other substances this may vary with the country.
Some countries have brought additional substances under their national regulations. This could be the case in some countries for ketamine injection 50mg/ml 10 ml-vial, promethazine tablets 25 mg, promethazine injection 25 mg/ml, 2ml-ampoule and chlorpromazine injection 25mg/ml, 2ml-ampoule.
At present there is an assessment going on, in order to decide whether ketamine needs to be brought under international control.
There are three international treaties that control narcotic and psychotropic substances:
• UN Single Convention on Narcotic Drugs (1961, amended by protocol of 1972)
• UN Convention on Psychotropic Substances (1971)
• UN Convention against the Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988).
These treaties are quite complex and it would go too far to go into details here. For the really interested, their texts can be found at the website of the International Narcotics Control Board (INCB) (www.incb.org ).
Those who need to consult the most recent lists of scheduled substances can find them at this website too.