The World Health Organization (WHO) published the full edition of its guideline on balanced national controlled medicines policies, marking the first comprehensive global framework designed to ensure access to controlled drugs for medical and scientific uses, while minimizing risks to public health that may arise due to misuse and diversion. This publication followed a rapid communication released during the Seventy-eighth World Health Assembly that outlined the new guideline.

Many controlled medicines, including opioids, benzodiazepines, barbiturates and amphetamines, are essential for managing pain, conducting surgeries, treating seizures, supporting palliative care, and managing mental health and substance use disorders — yet millions of patients worldwide still cannot access them.

According to WHO, up to 98% of patients in low-income countries lack access to adequate pain relief, while in other regions, weak safeguards have contributed to opioid-related epidemics. Across the world, adults and children with advanced cancer or living with HIV/AIDS continue to suffer in pain without morphine. In many regions, epilepsy patients go untreated because essential anti-seizure medicines are locked behind restrictive regulations and lack of education and understanding of how these medicines can be used clinically. Meanwhile, in many countries, insufficient regulation of controlled medicines has led to over-prescription and rising demand for strong opioids, driving a surge in health-related harms including substance use disorders, drug dependence and overdose.

The new WHO guideline calls for balanced national policies that both guarantee uninterrupted, affordable access and prevent harmful non-medical use of controlled medicines. It aims to help countries ensure safe, fair, and affordable access to essential controlled medicines that are vital for managing acute and chronic pain, mental health disorders, substance use disorders, and other serious health problems.

The WHO guideline provides governments with evidence-based recommendations covering seven key domains: policy development, pricing and financing, medicines selection, procurement and supply chain, regulation, prescribing and dispensing, and education for both health professionals and the public.