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Australian overdose deaths are increasing – and the demographics are changing


Amanda Lyons 30/08/2018 3:58:52 PM

This year’s annual report on Australian overdose deaths from the Penington Institute details significant – and sometimes surprising – changes over time in demographics and drug types.

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The report from the Penington Institute shows that accidental drug overdose deaths are increasing all across Australia, particularly in regional areas.

As International Overdose Awareness Day approaches, the Penington Institute released its Australia’s annual overdose report 2018 (the report) – and it makes for sobering reading.
 
Deaths by accidental drug overdose have consistently increased across the country over the past 15 years and now significantly outnumber the road toll.  
 
Penington Institute Chief Executive John Ryan said he is deeply concerned about the rising rates of Australia’s overdose deaths, and believes further comparison with the road toll is instructive.
 
‘We’ve got a lot to learn from the way the road toll was managed and reduced, in that it involved comprehensive action, there was not one simple solution,’ he told newsGP.
 
The report drills down into the types of drugs involved and the demographics of their users, revealing significant changes in these factors over time.
 
Opioids – a category that includes pharmaceuticals such as oxycodone and fentanyl, as well as illicit versions such as heroin – remain the main cause of accidental overdose death in Australia. Opioid-related deaths hovered at around 450 per year at the turn of the century, but since 2006 these numbers have risen sharply to hit over 1100 per year since 2014.
 
Deaths involving amphetamines have also been rising, increasing from 175 in 2013 to 442 in 2016. These drugs have in fact overtaken alcohol to become the third most common substance detected in accidental drug deaths within Australia.
 
However, rates of alcohol-related overdose deaths have also continued to increase, from around 200 deaths per year in 2001 to almost 400 per year since 2014. Alcohol is also a common factor in accidental overdose resulting from poly-drug use, especially when combined with other depressants such as prescription medication benzodiazepine.
 
The report also reveals the way the demographics of drug overdose deaths have changed in ways that often confound conventional assumptions. For example, although many people may associate drug overdose death with young people living in cities, it is middle-aged Australians who are more likely to die in this way, with almost 70% of all overdose deaths occurring between the ages of 30–59.
 
Accidental overdose deaths have also risen strongly in Australia’s regional areas and are now sitting at 8.1 per 100,000 compared to 6.6 in metropolitan areas; although it is worth noting the ratio of increase between 2015–16 was higher for metropolitan than regional areas, suggesting metropolitan areas are catching up to their regional cousins.
 
Other statistics may not be as surprising, such as the finding that men are twice as likely to die of accidental overdose than women. However, the rate of overdose death among women is growing at a faster rate than that of men overall.
 
There was also variation in rates across the states and territories: the Northern Territory and the Australian Capital Territory were the only two jurisdictions that did not record an increase in accidental drug overdose deaths during the comparison periods in the report. And while all of the others did experience increases, the largest were not found in the most populous states, but in Queensland and Western Australia, which had 1.6 and 1.9 times respective increases in accidental drug overdose deaths over the comparison period.
 
Mr Ryan believes the statistics contained within the report can help point the way towards much-needed solutions to Australia’s drug overdose issues. In his opinion, a major aspect of the problem is the way that the issue of drug use has been categorised within Australian society.
 
‘On a big-picture policy level, I think we don’t yet adequately acknowledge that drug-use matters, particularly overdose, are health sector issues that need to be managed by the health sector,’ he explained.
 
‘We can’t arrest our way out of drug problems, and the fact that many overdoses are pharmaceutical reinforces that point.
 
‘Yet we still think of drugs as mostly a policing and regulation issue, rather than a health and cultural issue.’
 
Mr Ryan said that increased access to drug treatment services, opioid substitution and blocking medications, and a greater role for GPs in management of drug dependence issues, would be key elements in tackling Australia’s increasing rates of drug overdose.
 
‘I think a local community-driven approach which puts GPs as a cornerstone in efforts in relation to drug use issues would be much more effective, and that applies to pharmaceutical drugs as much as it does to illicit drugs,’ he said.
 
‘That would involve mainstreaming dependence issues as part of general medicine, and giving GPs a greater role in relation to dependence issues, including the prescription of opioid substitution treatments.
 
‘At the moment, only one in four people that need treatment for drug dependence are receiving it in Australia.
 
‘I think there is an enormous untapped opportunity if GPs were able to take an increased and leading role in relation to dependence treatment.’


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International Overdose Awareness Dayoverdose deathsPenington Institute



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