Dispensing fees a barrier to addiction treatment

Australia is on track to emulate the US-style drug overdose crisis, a new report shows

The Penington Institute’s Australia’s Annual Overdose Report 2017 has shown that diverted fentanyl is killing hundreds of Australians.

According to Penington Institute CEO John Ryan, more needs to be done to reduce barriers to accessing opioid replacement therapy.

He criticised dispensing fees for such therapies as one barrier.

“One of the great triumphs in addiction treatment is pharmacotherapy programs such as opioid substitution treatment – this sort of treatment is highly effective at stabilising people in crisis situations,” Mr Ryan says.

“People who access methadone or buprenorphine currently pay dispensing fees –  a serious barrier to accessing treatment for many people.

“It is cheaper to be abusing pharmaceuticals than to be on medically assisted treatment – changing this would have enormous benefit for many people in the crisis of addiction.”

Mr Ryan also called for better community education, to target people experimenting with drug use before they develop an addiction.

He also highlighted the need to address stigma.

“The stigma in relation to drug use and drug addiction is one of the great barriers for people who are experiencing problems, whether they are family member or individuals with drug problems,” he says.

“This stigma also applies to some people in the healthcare profession. There are many excellent healthcare providers, but there is also a significant taboo in relation to drug use issues.

“Many people criticize the existing community response to drugs as being soft on drugs, when in fact it’s not.

“The majority of expenditure is directed towards supply reduction – law enforcement and the prison system. At the other end of the scale, harm reduction initiatives receive a tiny percentage of the funds directed towards tackling these issues.”

The report showed that since the early 2000s, the number of Australians aged 30 – 59 who overdosed has more than doubled.

More than twice as many Australians are now dying due to accidental overdose as compared to those dying from car accidents. 

A significant increase in deaths related to pharmaceutical opioids, street heroin, and fentanyl is also highlighted in the report.

In capital cities and regional areas, Australians are now far more likely to overdose on opioids including codeine and oxycodone then by sleeping tablets such as valium (benzodiazepines) followed by alcohol, and then amphetamines.

In 2015, there were a total of 2,023 drug-related deaths in Australia. This has increased from 1,313 deaths in 2001.

Men are having drug overdoses in much higher numbers than women. In 2005, accidental deaths due to drugs for males totalled 683, a figure which has steadily increased to 1,061 in 2015.

Women are also dying in greater numbers – from 2005 to 2015, there was a 1.4-fold increase in women dying from an accidental overdose (from 300 to 428).

The difference between accidental drug-related deaths (1,489 in 2015) and car accidents (712 in 2015) has never been so pronounced, with accidental drug-related deaths more than double the number of deaths associated with car accidents.

Accidental death due to drugs has consistently increased over the past 15 years, from 981 in 2001 to 1,489 in 2015.

Accidental overdose from opioids continues to overshadow accidental overdose from other drug types.

During 2011-2015, 3601 people died from overdose due to an opioid – a 1.6-fold increase from 2001-2005.

Accidental death from oxycodone, morphine, or codeine continues to be responsible for most opioid related deaths, recording 1,556 deaths over the period 2011-2015 (1.3 deaths per 100,000).

Australia has experienced a significant increase in fatal overdoses due to fentanyl, pethidine and tramadol. Between 2011 and 2015, 796 Australian’s overdosed on these drugs. Fentanyl is the major factor driving this increase in deaths.

Deaths from amphetamines have more than doubled for the period 2001-2005 to 2011-2015 across all jurisdictions. Queensland has experienced a significant growth in deaths attributed to amphetamines for this period with 25 deaths in 2001-2005 increasing to 179 deaths in 2011-15;   a per capita increase of 5.8 times (from 0.1 to 0.8 deaths per 100,000).

There has been a marked increase in overdose deaths across regional Australia.

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  1. PharmOwner

    Maybe if adequate dispensing fees were fully funded by government, then it would be more financially attractive for pharmacies to offer ORT. More pharmacies offering ORT, easier and cheaper access for patients. Greater uptake of patients with opioid addiction. Win-win.

    • Jarrod McMaugh

      One of the few universally-accepted points raised by the King Review. It really is an area that needs to be addressed sooner rather than later.

      Once that’s in place, the next thing is moving past the stereotypes….

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