OPIOIDS, a class of drugs that includes morphine and other derivatives of the opium poppy, can dramatically ease pain, from the agony of broken bones to terminal cancer. And they are cheap: enough morphine to soothe a cancer patient for a month should cost just $2-5. But the mismanagement of opioids has caused a pain crisis, with two faces. In America, Canada and some other rich countries, opioids have been overprescribed for chronic pain relief for decades. Millions became addicted in America; in 2014 nearly 20,000 people died from overdoses. Authorities are at last addressing the problem. In May, Congress passed 18 opioid-related bills, and the number of prescriptions has declined. The International Narcotics Control Board, an independent monitor that oversees the implementation of UN drug conventions, estimates that 92% of all morphine, commonly used to control the pain caused by cancer, is consumed in America, Canada, New Zealand, Australia, and parts of western Europe—which between them hold only 17% of the world’s population.

In developing countries, by contrast, opioids are too hard to come by. In Armenia, for example, morphine is only available to cancer patients, who must rush from ministry to ministry filling in forms to receive a few days’ supply. This is partly a consequence of America’s “war on drugs” that began in the 1970s. Poor countries, afraid of annoying Uncle Sam, introduced laws that were more restrictive than the UN recommends. The consequence is needless suffering.