For the years 2002-2004, the average defined daily dose consumption of morphine for statistical purposes (S-DDD)¹² in Kazakhstan was 4. This compares with other Commonwealth of Independent States as follows: Kyrgyzstan 3; Turkmenistan 2; Uzbekistan 3 (Table 2). These figures are the lowest for the region. The International Narcotics Control Board¹³ has published the following figures for the consumption of narcotic drugs in Kazakhstan (2003): codeine 941 kg; morphine 1 kg.

Table 2: Average daily consumption of defined daily doses (for statistical purposes) of morphine per million inhabitants, 2002-2004 Central and Eastern Europe/Commonwealth of Independent States (plus Mongolia)

Source: International Narcotics Control Board Narcotic Drugs: Estimated World Requirements for 2006. Statistics for 2002-2004. New York: United Nations, 2006.

In 2005, morphine hydrochloride was reported as the first opioid of choice for pain relief prescription at a cost of 29 euros per month. Promedol was the second most prescribed opioid for pain relief, although the cost of this drug is not known.¹⁴ Valeriy Viktorovich Smola describes some of the barriers to the adequate availability of strong opioids in Kazakhstan at the present time:

‘…the situation about opioids…has not been changed for the last ten years. Incurable patients are treated parenterally with morphine hydrochloride 0.1%. Palletizing or transdermal forms of opioids are not used in Kazakhstan, though the legislation allows using [them]… [There is a] lack of import of different forms of opioids (commercial organizations do not deliver other kinds of opioids but morphine as there is no special demand)…Doctors [possess] negative stereotypes, lack of knowledge and [lack of] clinical experience in the sphere of using any other kinds of opioids but solutions.’¹⁵