In 1961 the "Single Convention on Narcotic Drugs" was adopted by the United Nations to explicitly addressthe need for narcotic drugs to curtail suffering and keep the distribution of these drugs in the control of healthprofessionals. Fifty years later, neither goal has been reached for a variety of reasons. Governments haveavoided putting in place systems to assure adequate supplies to relieve the suffering of those with severe pain,drug enforcement agencies maintain restrictive regulations and physicians are intimidated by threats of legalaction if their prescribing patterns do not conform to arbitrary standards. There is a shortage of pain controlconsultants and the training for most health care providers is deficient when it comes to the management ofchronic pain. Some of the regulatory barriers have been successfully addressed through advocacy efforts andthe expertise deficiencies improved through targeted educational programs.