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Australia’s overdose crisis is ‘getting worse’


Evelyn Lewin


27/08/2019 2:50:46 PM

The last five years have seen a major increase in heroin, stimulant and polydrug overdoses, according to a new report.

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For the first time since 2003, heroin was involved in more unintentional overdose deaths than the next highest opioid group. (Image: Mick Tsikas)

‘It’s time to call this what it is: Australia’s very own overdose crisis.
 
‘And make no mistake; it’s a crisis that is getting worse.’
 
That is John Ryan, Chief Executive Officer of drug policy organisation, Penington Institute. He is discussing the results of Australia’s annual overdose report 2019, released this week.
 
According to the report, the number of Australians who died from unintentional overdoses has increased by almost 38% in 10 years, from 1171 fatalities to 1612.
 
Opioids – both pharmaceuticals and in illicit forms – continue to be the primary drug group associated with unintentional drug-related deaths. However, for the first time since 2003, heroin was involved in more unintentional overdose deaths than the next highest opioid group (oxycodone/morphine/codeine).
 
Benzodiazepines was the second most common group of drugs linked to unintentional overdoses, followed by stimulants such as methamphetamine or ice.
 
‘It’s very important to note that this is not, and never has been, only a crisis of illicit drugs,’ Mr Ryan said in a statement.
 
‘Not all stimulants are methamphetamines, and not all opioids that cause death are heroin,’ he said.
 
‘Australia has a problem with pharmaceutical drugs as well as illicit drugs.’
 
Those pharmaceutical-related overdoses included an increase in the number of drug-induced deaths involving anti-convulsant medications (from 0 in 2012 to 67 in 2017), and an increase in the number of unintentional drug-induced deaths involving anti-psychotics (from 21 in 2012, to 192 in 2017).
 
Mr Ryan told newsGP he questioned what contributed to the significant rise in heroin and methamphetamine overdoses.
 
‘Whether that’s because of more limited prescribing by doctors and people switching to illicit drugs – there’s no data for that – but it looks like we’re continuing our trajectory of people dying from overdose,’ he said.
 
When it comes to opioids, Mr Ryan said, Australia is careening ‘down a similar path’ to the US.
 
‘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,’ he said in a statement.
 
‘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.’
 
The report also found there has been:

  • a nearly three-fold increase in unintentional deaths involving stimulants in the last five years, from 156 to 417
  • a 2.4-fold increase in unintentional heroin overdose deaths, from 149 to 358
  • more than double the unintentional deaths involving benzodiazepines, from 256 to 583.
Another big change noted is the diversification away from single-drug to polydrug overdose.
 
‘More people overdose now on four-plus drugs than on a single drug,’ Mr Ryan told newsGP. ‘It’s an increasingly complex problem.’
 
He went on to say in a statement that healthcare professionals are more effective in terms of treating single-drug overdose.
 
‘But when you’re introducing multiple other types of drugs into a person’s system, the response can be hard to predict,’ he said.
 
While common perception may suggest unintentional overdoses are an issue that mainly affects young people, the report found Australians aged 30–59 accounted for the greatest burden of drug-induced deaths, with that demographic comprising 71.6% of all unintentional drug-induced deaths in 2017.
 
Furthermore, contrary to public perception, it is also an issue that affects Australians from all walks of life, with 22.5% of unintentional overdose deaths occurring in the most disadvantaged 20% of suburbs, compared to 18.4% in the most advantaged 20%.
 
The report also revealed that Aboriginal and Torres Strait Islander people were three times more likely to die from unintentional overdose than non-Indigenous Australians, and that stimulants were involved in a much higher proportion of drug-induced deaths for this demographic.
 
While the findings highlighted the severity of Australia’s overdose crisis, Mr Ryan said GPs are perfectly placed to help address this problem.
 
‘GPs are at the frontline of positive change in drug addiction,’ he said.
 
‘Dependence is often considered a bit of a speciality area rather than the mainstream issue it should be.’
 
Even though the number of unintentional overdose deaths continues to rise, Mr Ryan believes it is possible to change that trajectory.
 
‘We used to experience similar numbers of deaths on our roads,’ Mr Ryan said. ‘Australians said, “enough is enough”, and we’ve brought that number down.
 
‘We can turn this around before it’s too late.
 
‘If we apply the methods that we know are successful in reducing overdose deaths, we’ll save billions of dollars and, more importantly, save the lives of thousands of Australians.’



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Dr.Patrick McSharry MD MBA FRACGP   29/08/2019 2:01:54 AM

Hi. I was involved in Opioid Crisis Deaths and it's Mgt in 2 States in the USA and a Province in Canada. I agree with Mr. Ryan. The Australian Trajectory (in regards to "accidental overdose from Opioids ) is the same Trajectory as we experienced in Pennsylvania . The switch from Prescribed Opioids to illicit Opioids being very noticeable 5-10 years ago .
I'm interested in what strategies are being employed in Australia (I presume some are the same as we persued in the USA ( By the way Canada especially BC and ON are catching up on most USA states where 30 Deaths per 100,000 are attributed to "Accidental "Overdose) Though In West Virginia it is nearly 55/100,00
I presume MAT (Methadone and Suboxone ) are being prescribed by GP 's and Psychotherapy or Addiction Counseling are being employed in GP Practices?
Any assistance in learning about the treatment strategies in Australia is welcomed .


Tim Shannon   1/09/2019 12:17:41 AM

Most gps are ignorant about addiction and are fearful of using opiates to treat acute pain. Having 20 y experience in treating opiate addiction and the stigma that goes with that. I have to curb my tongue when these issues are bought up because they don’t understand and don’t want to know. Who wants to treat “drug addicts” but the tremendous gratitude patients have when they Finally find a GP who gets them and what problems they are facing and appropriate management is why I work in the field.


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