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Overdoses skyrocket

Wednesday, 4th September, 2019

GP Superclinic’s Dr Funmi Komolafe. PICTURE: Callum Marshall GP Superclinic’s Dr Funmi Komolafe. PICTURE: Callum Marshall

By Callum Marshall

The number of Australians dying from unintentional drug overdoses has skyrocketed by almost 38 per cent over the last decade, according to a report released last week.

Australia’s Annual Overdose Report 2019, by the Penington Institute, has highlighted that 1,612 people died of unintentional overdoses in 2017 compared with 1,171 in 2003.

Underpinning this rise, notes the report, is a nearly three-fold increase in unintentional deaths involving stimulants (including methamphetamine) in the last five years, from 156 to 417 deaths.

On top of that, there’s been a 2.4-fold increase in unintentional heroin overdose deaths since 2012 and a more than doubling in unintentional deaths involving benzodiazepines.

Last week, the CEO of Penington Institute John Ryan said Australia was “careening down a similar path as America” when it came to opioids.

“About seven years ago, their overdose deaths from prescription opioids began to stabilise as deaths due to illicit drugs like heroin, fentanyl and methamphetamine skyrocketed,” said Mr Ryan.

“Reducing access to prescription drugs without addressing the underlying causes simply changes the type of drugs that are abused - with fatal consequences. 

“Australia shouldn’t follow America’s failed approach.”

“But it’s very important to note that this is not, and never has been, only a crisis of illicit drugs.

“Not all stimulants are methamphetamines, and not all opioids that cause death are heroin.

“Australia has a problem with pharmaceutical drugs as well as illicit drugs.”

Another concern was the rise in accidental overdoses in regional areas, overtaking the number of deaths in metropolitan areas since the beginning of the decade.

There were 6 deaths per 100,000 people in metro areas at the start of the decade compared with 5.9 for regional areas. The 2017 figures were 6.3 and 7.3, respectively.

“What’s happening in regional Australia should also greatly concern us,” said Deputy CEO of Penington Institute Dr Stephen McNally.

“As recently as the beginning of the decade, Australians in rural and regional areas faced the same risk as Australians living in metro areas. 

“Today, the rate of unintentional overdose deaths is significantly higher in rural and regional areas.”

Local GP Dr Funmi Komolafe said the rise was “alarming” and that several things could be done to help address the problem.

“It all boils down to increasing the support in the regional areas, increasing the awareness and maybe reducing the stigma associated with being involved with illicit drug abuse,” said Dr Komolafe.

“Because some of the unintentional drug overdose relates to medications that have been prescribed, or at least prescription medications, I think maybe doctors, GPs and prescribers, maybe need to increase the level of patient education when these medications are prescribed.”

That would include potentially restricting the medication quantity, she said, as well as making sure proper medication reviews were being administered and that medications were not being repeated without assessing the patient again.

That, alongside better communication between pharmacists and doctors in the prescription and management of patient medications, community awareness and the reduction of alcohol use, would go some way to helping address the issues, said Dr Komolafe.

“Reduction of alcohol use will also help because a lot of these unintentional overdoses often have alcohol linked one way or the other,” she said.

“And unfortunately there’s a high increase of alcohol consumption in regional areas as well.”

She said more awareness was key.

“One thing I’ve noticed is families and relatives suffer a lot from some of these situations even before it becomes an overdose.

“The actual fact that a family member realises that their loved one is involved in illicit drug use is very distressing, and while they confide and talk to the GP about it there’s not much that the clinician can do when the patient has not come forward to ask for help. 

“You can only support the patient and give them tips, and maybe link them to services they could recommend for their loved one. But the loved one needs to be willing to accept the help.

“Having those who are exposed to the use of those illicit drugs, having them becoming willing to accept help, is often the challenging part.

“They might actually come forward but sometimes they don’t maintain that connection that would see them through to being able to overcome that drug addiction or the addictive tendencies.

“(But what would also be helpful) is a multi-sectorial, multi-disciplinary approach to address the problems.

“Clinicians, pharmacists, nurses and the hospital working with police, the justice system and local council to develop regional-specific programs tailored to the community with an emphasis on prevention of use of illicit drugs and the misuse of prescribed drugs.”

A NSW Health spokesperson said a state-wide opioid treatment program was in place and its access was being increased.

“The NSW Government has committed $231.6 million to alcohol and other drug services in this year’s budget, with more than $850 million invested in these services over the next four years,” said the spokesperson.

“NSW Health delivers a state-wide opioid treatment program and is increasing its access for vulnerable populations.

“Opioid treatment is a successful public health program that reduces health, social and economic harms experienced as a result of illicit opioid use, including the illicit use of prescription opiates.

“Naloxone is a life-saving medicine to reverse opioid overdose which can be prescribed to a patient by a doctor and subsidised by the PBS or purchased at a community pharmacy.

“NSW Health is also increasing access to a ‘take home’ naloxone program for vulnerable populations that is being delivered through drug and alcohol services and needle and syringe programs.

“For information and referral please call the Drug and Alcohol Helpline on 1300 652 226.”

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