Coroner recognises GPs amid drop in overdose deaths

Overdose deaths in Victoria have reached a 10-year high, with a Coroners Court of Victoria report, released this week, revealing 584 Victorians died from overdose in 2024.
 
This is compared to 547 deaths in 2023, and 460 in 2015.

While the overdose death rate remained around 8.1 deaths per 100,000 people between 2015–24, the report found a significant spike in illegal drug involvement in recorded fatalities.
 
It found most overdose deaths are from multiple drug toxicity.
 
Last year, illegal drugs contributed to two thirds of Victorian overdose deaths, most notably heroin, methamphetamine, MDMA, cocaine and GHB.
 
The proportion of deaths involving alcohol remains consistent, at 24.1% in 2024.
 
However, the proportion of deaths involving pharmaceutical drugs continues to decline, accounting for 69.3% of deaths in 2024, down from 78% in 2015.
 
In response to these findings, the report acknowledges the RACGP’s ‘concerted effort over an extended period’ to support clinicians’ opioid and benzodiazepine prescribing practices.
 
‘A number of initiatives, such as the RACGP disseminating its prescribing guidelines and the SafeScript implementation, may have been responsible for this decline in the proportion of Victorian overdose deaths involving pharmaceutical drugs,’ it said.
 
Dr Marguerite Tracy, RACGP Expert Committee – Quality Care member and alcohol and other drugs spokesperson, said while rising rates of overdose deaths ‘remain a concern’, she is pleased to see the proportion of prescribed medications decreasing.
 
‘GPs already provide high-quality and impactful care to vulnerable members of their communities,’ she told newsGP.
 
‘I would encourage all my colleagues to incorporate opioid dependence treatment prescribing into their usual care – methadone and buprenorphine are both highly effective medication and buprenorphine in particular is becoming very feasible for GPs to assist people with opioid use disorder.
 
‘We need to ensure that all governments adequately fund primary care to do this work and also specialist services for when people need to be referred for additional support.’
 
The report also reveals that men are twice as likely as women to die from overdose, with people aged 35–54 most at risk. 
 
The annual number of methamphetamine-involved overdose deaths in Victoria more than tripled from 2015–24, with a 30% jump in deaths between 2023–24.
 
There were 48 overdose deaths involving new psychoactive substances in 2024, with the substances remaining a ‘closely monitored concern’ due to their inclusion of ‘risky drugs such as nitazenes’ and their rapid evolution.
 
The report also reveals three quarters of overdose deaths across the decade were accidental or unintentional.

Victorian State Coroner Judge John Cain said ‘no community escapes’ the impact of drug overdoses.
 
‘We have seen some genuine progress in harm-reduction initiatives recently, including the commencement of Victoria’s drug checking trial,’ he said.

‘However, the concerning rise in overdose deaths and especially those involving illegal drugs is a stark reminder that we need to keep building on our harm-reduction efforts.’
 
Earlier this month it was revealed landmark opioid prescribing clampdowns are leading to a ‘reassuring’ downward trend in emergency presentation, but this has brought with it a spike in visits for other drugs.
 
With GPs prescribing around half of Australia’s opioids, Dr Tracy said they can also discuss with patients how to access and use take-home naloxone when prescribing opioid medications.
 
‘We have real-time prescription monitoring services which can be used in practice to support decisions when prescribing and open up opportunities to discuss problematic or unsafe medication use with our patients,’ she said.
 
‘When we have patients on prescription medications which are frequently implicated in overdoses such as opioids, benzodiazepines and pregabalin, we have an opportunity to discuss the harms of these.’
 
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