A/HRC/10/44 page 23 4 million terminal cancer patients, patients suffering injuries, caused by accidents and violence, patients recovering from surgery, women in labour, patients with chronic illnesses and paediatric patients”.61 70. Apart from poverty and lack of access to medical care in general, this appears to be partly caused by strict narcotic drug control laws and practices devised at the national level, sometimes underpinned by international drug control policies, at least in the past. In 1999, the International Narcotics Control Board acknowledged that “outdated restrictive regulations and, more frequently, uninformed interpretations of otherwise correct regulations, misguided fears, and ingrained prejudices about using opioids for medical purposes continue to prevail in many countries”. Similarly, in 2007, the Board stated that “the low levels of consumption of opioid analgesics for the treatment of pain in many countries, in particular in developing countries, continue to be a matter of serious concern to the Board. The Board again urges all Governments concerned to identify the impediments in their countries to the adequate use of opioid analgesics for the treatment of pain and to take steps to improve the availability of those narcotic drugs for medical purposes, in accordance with the pertinent recommendations of WHO”.62 E. Conclusions and Recommendations 71. With regard to human rights and drug policies, the Special Rapporteur wishes to recall that, from a human rights perspective, drug dependence should be treated like any other health-care condition. Consequently, he would like to reiterate that denial of medical treatment and/or absence of access to medical care in custodial situations may constitute cruel, inhuman or degrading treatment or punishment and is therefore prohibited under international human rights law. Equally, subjecting persons to treatment or testing without their consent may constitute a violation of the right to physical integrity. He would also like to stress that, in this regard, States have a positive obligation to ensure the same access to prevention and treatment in places of detention as outside. 72. Similarly, the Special Rapporteur is of the opinion that the de facto denial of access to pain relief, if it causes severe pain and suffering, constitutes cruel, inhuman or degrading treatment or punishment. 73. To address the many tensions between the current punitive approach to drug control and international human rights obligations, including the prohibition of torture and cruel, inhuman and degrading treatment, the Special Rapporteur calls on the Human Rights Council to take up the question of drug policies in the light of international obligations in the area of human rights at one of its future sessions. 61 62 WHO background note: Access to Controlled Medications Programme, September 2008. Report of the International Narcotics Control Board for 2007, New York. See also WHO, Achieving balance in national opioids control policy. Guidelines for Assessment Geneva, 2000, available at www.painpolicy.wisc.edu/publicat/00whoabi/00whoabi.pdf.