Turkiye
The highest-consuming middle-income country in the register's opioid sales series, and the case where service building and reimbursement are documented in sequence.
8 domains reviewed · 4 high-confidence · 4 dated estimates · 6 material gaps
WHO region: Europe. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 8 of 9
- Hospice: 3 of 4
- Backed by a primary document
- 1 of 9
- Open questions
- 10
- Sources behind this dossier
- 15
- Newest source 2026
Lessons from Turkiye
- Where no hospice exists, dying patients default to hospitals and intensive care units, so the hospital death rate is a practical signal of the gap.321,320
- A charity-funded residential hospice closed within four years, while bringing hospital palliative care beds under national social insurance was followed by growth to 397 units and 5717 beds by 2020.367,39
- Having a paediatric palliative care unit in a hospital is linked to paediatricians feeling far more competent in pain and symptom management.636
Palliative care
Is morphine available in Turkiye?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 25.37 MME per 1,000 people per dayCONFLICTING SOURCES
Opioid analgesic consumption, Turkiye, 20153
Method: IQVIA MIDAS pharmaceutical sales data for opioid analgesics, in morphine milligram equivalents per 1,000 inhabitants per day (Ju et al. 2022; abstract read September 2026). A sales-based proxy for availability, not a measure of palliative access. Last checked 2026-09-25.
A second table in the same supplementary appendix gives 25.16 for 2015 and 24.27 for 2019. Both readings show a modest decline across the period.
Other source: 25.16. A second table in the same supplementary appendix of Ju et al. gives 25.16 for 2015 (and 24.27 for 2019).3
Cite this figure: - 24.19 MME per 1,000 people per daySOURCE-CHECKED · 2019 DATA
Opioid analgesic consumption, Turkiye, 20193
Method: IQVIA MIDAS pharmaceutical sales data for opioid analgesics, in morphine milligram equivalents per 1,000 inhabitants per day (Ju et al. 2022; abstract read September 2026). A sales-based proxy for availability, not a measure of palliative access. Last checked 2026-09-25.
Cite this figure:
How does Turkiye regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
The 2015 Ministry of Health directive on palliative care services restructured inpatient units and linked family physicians to home care.38
Consumption fell across the same period in which services grew. What accounts for the divergence?
Help answer it:Search PubMedWho can prescribe morphine in Turkiye?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
How does palliative care reach patients in Turkiye?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 415 centresSOURCE-CHECKED · 2020 DATA
Palliative care centres, Turkiye, 202039
Last checked 2026-09-07.
Cite this figure: - 5,577 bedsSOURCE-CHECKED · 2020 DATA
Palliative care bed capacity, Turkiye, 202039
Last checked 2026-09-07.
Cite this figure: - 0.48 services per 100,000SECONDARY SOURCE
Specialised palliative care services per 100,000 people, Turkiye, 202540
Last checked 2026-09-07.
Cite this figure:
Growth ran through inpatient units inside the ministry system and through home care teams together, across all provinces.39,40
Who pays for palliative care in Turkiye?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Inpatient palliative care has been reimbursed by the Social Security Institution since 2014, through the healthcare implementation notification rather than a dedicated statute.40
Is outpatient opioid analgesia reimbursed on the same footing?
Help answer it:Search PubMedHow are palliative care clinicians trained in Turkiye?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
Palliative medicine is not recognised as an independent specialty or a subspecialty; service structure rests on ministerial directive instead.40
How does Turkiye prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Strong opioids in Turkiye are written on a separate red prescription under a color-coded system, which a national review names as one barrier alongside opiophobia. Consumption rose to 12.2204 mg morphine equivalence per capita in 2011 against a global average of 61.66. In a 2024 survey, 38.1% of oncology-department physicians were reluctant to prescribe opioids, linked to fear of opioid use disorder and lack of training.39,634
Does Turkiye offer methadone or buprenorphine treatment and take-home naloxone, and has the red prescription process been simplified since 2020?
Help answer it:Search PubMedHow do children get palliative care in Turkiye?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
The first palliative care unit for children opened at Dokuz Eylul University in 2011, and by February 2020 there were 10 paediatric palliative care services with 119 beds. Paediatricians working in hospitals with a paediatric unit felt competent in pain management far more often (36.8% vs 6.4%).39,636
Which oral morphine formulations suitable for children are available, and how many children do paediatric services reach each year?
Help answer it:Search PubMedHospice care in Turkiye
How the hospice model works here, who can use it, who pays and who it reaches. Covered 3 of 4.
What does hospice care look like in Turkiye?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Turkish sources describe hospice services as absent. Dying patients are cared for in hospitals, including palliative care units and intensive care units, through hospital-based home health services, or at home by family. Local papers use 'hospice' for a missing service and 'palliative care' for existing hospital units.320,322,321
Has any hospice-type unit or program been piloted in Turkey since 2022, and under which ministry or NGO?
Help answer it:Search PubMedWho can get hospice care in Turkiye?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
No hospice exists, so no hospice entry criteria were found. What criteria govern admission to hospital palliative care units and hospital-based home health services, and how late are referrals?
Help answer it:Search PubMedWho pays for hospice care in Turkiye?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Hospice has little presence in Turkey: a 2007 EAPC survey counted one hospice center, and a 2021 review says it is time to invest in hospice care. End-of-life inpatient care runs through hospital palliative care centers, and Social Security, which covers 98.6% of residents, began reimbursing inpatient palliative care in 2014. The first charity-run Cancer Nursing Home opened in 1993 and closed in 1997 because it could not raise enough money.39,367,322
Does Social Security reimbursement extend to home-based end-of-life care, and what are the per-day rates for palliative care center beds?
Help answer it:Search PubMedHow many people reach hospice in Turkiye?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
In one Ankara university hospital cohort of COPD patients (2014-2021), 77.3% died in hospital, and the authors link this to too few nursing homes and lack of hospice care. In Manisa, caregivers of terminal cancer patients cared for them at home with their own means because there was no hospice care.321,320
What share of deaths nationally occur in hospital or intensive care, broken down by cancer and non-cancer causes?
Help answer it:Search PubMedWhat fills the gap in Turkiye
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
In a Manisa study, family members cared for people with terminal cancer at home with their own means because hospice services were absent. In one hospital palliative unit, 8 family caregivers described emotional strain and physical exhaustion and drew on spiritual beliefs and peer support.320,447
Subnational evidence- Faith communities
At one Ankara cancer center, prayer was the most frequent complementary practice, reported by 1,433 of 1,499 surveyed outpatients.448
Single-site evidence- Community health workers and home-based care
Nurses in a state hospital Home Health Services Unit deliver end-of-life care at home and described learning palliative skills through apprenticeship after starting with insufficient training. Single-site study of 12 nurses.450
Single-site evidence- Traditional and complementary healers
Among 67 women with gynecologic cancer at one hospital, 61.2% used complementary therapies, most often herbal remedies, alongside standard treatment. Information came mainly from friends and family, and 56.1% of users had discussed it with their physician or nurse.449
Single-site evidence
Sources cited here
- 3Ju C, Wei L, Man KKC, et al.
Global, regional and national trends in opioid analgesic consumption, 2015 to 2019. Lancet Public Health 2022;7:e335-46. DOI 10.1016/S2468-2667(22)00013-5.
- 38Turkish Ministry of Health, General Directorate of Health Services.
Palyatif Bakim Hizmetlerinin Uygulama Usul ve Esaslari Hakkinda Yonerge, the directive on procedures and principles for palliative care services, dated 8 July 2015. Restructured inpatient palliative units and linked family physicians to home care.
- 39Kutluk T, Ahmed F, Cemaloğlu M, Aydın B, Şengelen M, Kirazlı M, et al.
Progress in palliative care for cancer in Turkey: a review of the literature. Ecancermedicalscience 2021;15:1321. DOI 10.3332/ecancer.2021.1321. PubMed Central PMC8723752. Service counts by year, including the February 2020 national position on centres, beds, staff and provinces.
- 40European Association for Palliative Care.
Atlas of Palliative Care in the European Region 2025, Turkiye country report, University of Navarra. Specialised service count and rate per 100,000 inhabitants; 2014 Social Security Institution reimbursement of inpatient palliative care through the healthcare implementation notification rather than a dedicated statute; palliative medicine not recognised as an independent specialty or subspecialty.
- 634Turan SA, Yentek Balkanay A, Aydın Ş.
Prevalence of Reluctance to Prescribe Opioids Among Physicians in Oncology Departments: A Descriptive Cross-Sectional Study From Turkey. J Pain Palliat Care Pharmacother 2024;38(2):123-130. Online survey of 278 oncology-department physicians (of 1000 invited) on reluctance to prescribe opioids; self-selected sample. Abstract read.
- 635Harputluoğlu N, Çubukçu D, Yılmaz Ü, et al.
Investigation of care burden and musculoskeletal pain of parents of paediatric palliative care patients in Turkey. East Mediterr Health J 2021;27(8):569-576. Cross-sectional study of 69 caregiving parents at one paediatric palliative care center in Izmir; single-site scope. Abstract read.
- 636Durmaz N, Vehapoglu A, Ersoy M, et al.
Impact of presence of paediatric palliative care units in hospitals on the confidence, knowledge and attitudes of paediatricians: the case of Turkey. East Mediterr Health J 2021;27(8):593-600. Multicentre 2019 survey of 199 paediatricians comparing hospitals with and without PPC units. Abstract read.
- 320İşler AM, Yıldırım B
The Need for Hospice Care as a Preferred Environment of Death in Terminal Cancers: A Neglected Research Area in Turkey. J Soc Work End Life Palliat Care 2022;19(1):53-83. Qualitative study of 18 oncology professionals and 5 bereaved caregivers in Manisa reporting that hospice services are absent in Turkey and families care for dying cancer patients at home or in hospital; single city. Abstract read.
- 322Ozdemir T, Ozdilekcan C, Goksel F
The contribution of hospital-based home health services in pulmonary diseases: Current Practice in Turkey. Medicine (Baltimore) 2019;98(48):e18032. Ministry of Health data on hospital-based home health services for respiratory disease 2011-2017, framed as a model for countries with inadequate hospice-type infrastructure. Abstract read.
- 321İdikut A, İnam MG, Karadeniz Güven D, et al.
An 8-year observational study of the death places of patients with COPD in Turkey. Geriatr Gerontol Int 2023;23(12):938-944. Retrospective cohort of COPD patients from one university hospital in Ankara (2014-2021); 77.3% died in hospital and authors cite lack of hospice care; single site. Abstract read.
- 367Can G.
Development of Cancer Palliative Care in Turkey. Florence Nightingale J Nurs 2023;31(Supp1):S52-S58. Narrative review; reports the charity-run Cancer Nursing Home (1993-1997) closing for lack of funds, palliative care centers brought under social security in 2014, and 397 units with 5717 beds by October 2020. Single-author review. Full text read.
- 447Sert Yurdakul S, Erbay Erşen M, Özel D
Witnessing the end, supporting the living: A qualitative study of palliative caregiving in end-of-life patients in Türkiye. Palliat Support Care 2026;24:e55. Phenomenological study of 8 family caregivers in one hospital-based palliative care unit describing burdens and coping through spiritual beliefs and peer support; very small sample. Abstract read.
- 448Yalcin S, Hurmuz P, McQuinn L, et al.
Prevalence of Complementary Medicine Use in Patients With Cancer: A Turkish Comprehensive Cancer Center Experience. J Glob Oncol 2017;4:1-6. Survey of 1,499 outpatients at one Ankara cancer center showing prayer as the most common complementary practice; single tertiary center. Abstract read.
- 450Oğuz Karaalp İ, Kalanlar B
Palliative care nursing journey in home healthcare: A grounded theory study. Geriatr Nurs 2026;70:103985. Grounded theory study of 12 nurses in the Home Health Services Unit of one state hospital describing how they learn palliative care on the job; single site. Abstract read.
- 449Nazik E, Nazik H, Api M, et al.
Complementary and alternative medicine use by gynecologic oncology patients in Turkey. Asian Pac J Cancer Prev 2012;13(1):21-5. Cross-sectional survey of 67 women with gynecologic cancer at one hospital showing herbal therapy as the main complementary method, learned mostly from friends and family; small single-site sample. Abstract read.