Linda Arthur, 48, from Alberta, Canada, who suffers from chronic pain and would like the UAE to allow Codeine.
Linda Arthur, 48, from Alberta, Canada, who suffers from chronic pain and would like the UAE to allow Codeine.

Doctors and patients push to end ban on poppy-based painkillers



Abu Dhabi // Doctors and patients are calling for the UAE to reconsider its ban on opioids - drugs derived from the poppy that are widely used as painkillers in Europe and North America. "Patients are missing out on one arrow in the quiver that might potentially help them," said Dr Michael Clark, associate professor and director of chronic pain treatment programmes at Johns Hopkins medical institutions.

"It's like saying, 'What if we didn't have penicillin?' You might be able to make do with the antibiotics you have left, but there might be a lot of people who could benefit, more cheaply, more completely with penicillin. The same argument is held for opioids." Pain management improves the quality of life for chronic pain sufferers, experts say, and eases the burden on the healthcare system and society, as patients are more likely to continue normal lives.

The opioid class of drug, which includes codeine, is controversial because of its addictive properties. In many countries it is used liberally by people with terminal illnesses, to reduce their suffering. It is often used for cancer and surgical patients, with the intake closely monitored by their doctors. "In places like the UAE, narcotics are restricted because of the fear of drug abuse," Dr Clark said. "If we get someone without an addictive personality and we give this for a legitimate problem, we think [the risk of their becoming addicted] is pretty low, but it is probably not zero."

Some prescription or over the counter medicines bought in other countries are illegal in the UAE, including codeine, a common pain relief medication which is an alkaloid occuring in opium and poppy seeds. In 2005, Tracy Wilkinson, 27, was arrested at Dubai airport for possessing the drug, which had been prescribed for back pain. She was held in custody for two months before being released after a letter from her doctor in the UK confirmed the codeine was for medical purposes only. Mrs Wilkinson had faced four years in jail if found guilty.

The Ministry of Health, which regulates drugs in the Emirates, was unavailable to comment. The pain clinic at Tawam Hospital in Al Ain is hosting a pain management conference on October 27-28 which will explore these issues. Dr Rasha Jabri, the head of the clinic, said she had seen the effect of giving patients unlimited pain medication when she was training in the United States. "The UAE and the surrounding countries are on the other extreme, which is no opioids at all," Dr Jabri said. "What we need is a balanced way to give the medication to the people who need it with good regulation. The extreme reaction of not having opioids at all is not good for the patient."

Dr Jabri thinks regulation can reduce the risk for abuse, allowing patients to get the benefits of opioids and lower their chances of becoming addicts. She also believes pain management is an essential part of medical care. "I wouldn't say controlling pain is only for quality of life although it is very important to be humane and not let people suffer but it does change your outcome in a medical situation," she said.

Patients who had undergone chest or upper abdomen operations could die from complications of their pain, if they did not receive adequate medication. "A total knee replacement is one of the most painful surgical procedures that a patient can have," Dr Jabri said. "If you don't have adequate pain relief after the surgery, then the surgery will fail. Not because of the surgical technique, but the patient will not be able to do the rehabilitation necessary to increase the range of motion in the knee.

"Severe pain, like surgical pain or cancer pain, is severe enough to warrant having opioids in the regimen." Linda Arthur has suffered chronic back pain since November, when complications from a medical procedure left her walking with a cane and dependent on painkillers. "I am on all kinds of pain medicines, but I don't take near the amount they prescribe because then I can't function," said Ms Arthur, a 47-year-old English tutor from Al Ain.

"It is hard on the family and myself. In dealing with the pain I might be OK for a little bit, when I can get up and do things, but after walking around for a little bit I can't do it any more. I have to come home and rest." She thinks the Government should consider adding some opioids to the list of controlled substances that doctors can prescribe. "Be it cancer patients or chronic pain patients, we have to have codeine. It is number one on my list of drugs that we really should have here," Ms Arthur said. "The hospitals' favourite thing to prescribe for pain is Panadol, and I think that's good for a headache, but not after surgery, not for chronic pain."

She said she did not enjoy taking painkillers, but regarded it as a necessity. "I want to live life, and unfortunately I will always be on medication." she said. "I cannot function on the amount they have to give me because other medications are not available here." amcmeans@thenational.ae

ENGLAND SQUAD

Goalkeepers: Jack Butland, Jordan Pickford, Nick Pope 
Defenders: John Stones, Harry Maguire, Phil Jones, Kyle Walker, Kieran Trippier, Gary Cahill, Ashley Young, Danny Rose, Trent Alexander-Arnold 
Midfielders: Eric Dier, Jordan Henderson, Dele Alli, Jesse Lingard, Raheem Sterling, Ruben Loftus-Cheek, Fabian Delph 
Forwards: Harry Kane, Jamie Vardy, Marcus Rashford, Danny Welbeck

Real estate tokenisation project

Dubai launched the pilot phase of its real estate tokenisation project last month.

The initiative focuses on converting real estate assets into digital tokens recorded on blockchain technology and helps in streamlining the process of buying, selling and investing, the Dubai Land Department said.

Dubai’s real estate tokenisation market is projected to reach Dh60 billion ($16.33 billion) by 2033, representing 7 per cent of the emirate’s total property transactions, according to the DLD.

LEADERBOARD
%3Cp%3E-19%20T%20Fleetwood%20(Eng)%3B%20-18%20R%20McIlroy%20(NI)%2C%20T%20Lawrence%20(SA)%3B%20-16%20J%20Smith%3B%20-15%20F%20Molinari%20(Ita)%3B%20-14%20Z%20Lombard%20(SA)%2C%20S%20Crocker%20(US)%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ESelected%3A%20%3C%2Fstrong%3E-11%20A%20Meronk%20(Pol)%3B%20-10%20E%20Ferguson%20(Sco)%3B%20-8%20R%20Fox%20(NZ)%20-7%20L%20Donald%20(Eng)%3B%20-5%20T%20McKibbin%20(NI)%2C%20N%20Hoejgaard%20(Den)%3C%2Fp%3E%0A
NO OTHER LAND

Director: Basel Adra, Yuval Abraham, Rachel Szor, Hamdan Ballal

Stars: Basel Adra, Yuval Abraham

Rating: 3.5/5

The specs

Engine: Four electric motors, one at each wheel

Power: 579hp

Torque: 859Nm

Transmission: Single-speed automatic

Price: From Dh825,900

On sale: Now

The specs
 
Engine: 3.0-litre six-cylinder turbo
Power: 398hp from 5,250rpm
Torque: 580Nm at 1,900-4,800rpm
Transmission: Eight-speed auto
Fuel economy, combined: 6.5L/100km
On sale: December
Price: From Dh330,000 (estimate)
COMPANY%20PROFILE
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Brief scores:

Manchester City 3

Aguero 1', 44', 61'

Arsenal ​​​​​1

Koscielny 11'

Man of the match: Sergio Aguero (Manchester City)

Thor: Ragnarok

Dir: Taika Waititi

Starring: Chris Hemsworth, Tom Hiddleston, Cate Blanchett, Jeff Goldblum, Mark Ruffalo, Tessa Thompson

Four stars

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

The National's picks

4.35pm: Tilal Al Khalediah
5.10pm: Continous
5.45pm: Raging Torrent
6.20pm: West Acre
7pm: Flood Zone
7.40pm: Straight No Chaser
8.15pm: Romantic Warrior
8.50pm: Calandogan
9.30pm: Forever Young

The White Lotus: Season three

Creator: Mike White

Starring: Walton Goggins, Jason Isaacs, Natasha Rothwell

Rating: 4.5/5

The specs: 2018 Nissan 370Z Nismo

The specs: 2018 Nissan 370Z Nismo
Price, base / as tested: Dh182,178
Engine: 3.7-litre V6
Power: 350hp @ 7,400rpm
Torque: 374Nm @ 5,200rpm
Transmission: Seven-speed automatic
​​​​​​​Fuel consumption, combined: 10.5L / 100km

At a glance

Global events: Much of the UK’s economic woes were blamed on “increased global uncertainty”, which can be interpreted as the economic impact of the Ukraine war and the uncertainty over Donald Trump’s tariffs.

 

Growth forecasts: Cut for 2025 from 2 per cent to 1 per cent. The OBR watchdog also estimated inflation will average 3.2 per cent this year

 

Welfare: Universal credit health element cut by 50 per cent and frozen for new claimants, building on cuts to the disability and incapacity bill set out earlier this month

 

Spending cuts: Overall day-to day-spending across government cut by £6.1bn in 2029-30 

 

Tax evasion: Steps to crack down on tax evasion to raise “£6.5bn per year” for the public purse

 

Defence: New high-tech weaponry, upgrading HM Naval Base in Portsmouth

 

Housing: Housebuilding to reach its highest in 40 years, with planning reforms helping generate an extra £3.4bn for public finances

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COMPANY PROFILE
Name: Kumulus Water
 
Started: 2021
 
Founders: Iheb Triki and Mohamed Ali Abid
 
Based: Tunisia 
 
Sector: Water technology 
 
Number of staff: 22 
 
Investment raised: $4 million 
UAE currency: the story behind the money in your pockets
COMPANY%20PROFILE
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Diriyah%20project%20at%20a%20glance
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The rules on fostering in the UAE

A foster couple or family must:

  • be Muslim, Emirati and be residing in the UAE
  • not be younger than 25 years old
  • not have been convicted of offences or crimes involving moral turpitude
  • be free of infectious diseases or psychological and mental disorders
  • have the ability to support its members and the foster child financially
  • undertake to treat and raise the child in a proper manner and take care of his or her health and well-being
  • A single, divorced or widowed Muslim Emirati female, residing in the UAE may apply to foster a child if she is at least 30 years old and able to support the child financially
How the bonus system works

The two riders are among several riders in the UAE to receive the top payment of £10,000 under the Thank You Fund of £16 million (Dh80m), which was announced in conjunction with Deliveroo's £8 billion (Dh40bn) stock market listing earlier this year.

The £10,000 (Dh50,000) payment is made to those riders who have completed the highest number of orders in each market.

There are also riders who will receive payments of £1,000 (Dh5,000) and £500 (Dh2,500).

All riders who have worked with Deliveroo for at least one year and completed 2,000 orders will receive £200 (Dh1,000), the company said when it announced the scheme.