Mindset change needed on addictive pharmaceuticals


Pharmacists can play a key role in reducing the impact of Australia’s “pill-popping” culture, say stakeholders as a new campaign launches to combat the problem

The Alcohol and Drug Foundation has today released a campaign to reduce the impact of pharmaceutical medicine misuse, following the publication of its Prevention Research report, “Is there a pill for that?” which identifies benzodiazepines, codeine and other opioids as a major cause of mortality and morbidity.

The report identifies that more Australians are dying from pharmaceutical overdoses than all illegal drugs combined – and are overtaking our national road toll.

The number of people dying after using codeine has doubled in the past decade, the ADF highlights. Most overdoses are accidental and often the result of misuse such as mixing alcohol with medications, or mixing medications.

The campaign features a series of videos in which everyday Australians reveal the impact of dependency on addictive medicines on their lives.

ADF spokesperson Ilka Burnham-King told the AJP that a mindset change, similar to that seen in efforts to combat microbial existence, is needed to counter Australians’ desire for “magic bullet” solutions to chronic, complex problems such as pain or mental illness.

“I remember when we’d go to the doctor coughing and spluttering with a blocked-up nose, and walk out with a script for antibiotics because that’s what we wanted – we’d paid to see the doctor and wanted something to walk away with,” she says.

“Now we can go in and they’ll just say, ‘Rest for two days’. There’s been a massive push and collaboration to change that culture of giving out antibiotics; it wasn’t doctors’ fault, or pharmacists’ fault, or patients’ fault, but everybody has a piece of that responsibility.

“We can do the same with addictive pharmaceuticals, and pharmacists can be part of that, prompting the individual to ask, ‘Have I been on this too long? Do I have a problem with my use? Are there alternatives?’”

The fact that pharmacists’ role is evolving so quickly is “brilliant” for drug misuse stakeholders, she says.

“All the research and statistics show that a significant proportion of people who are dependent on these addictive medicines have no idea that they are,” she says.

“So I see pharmacists playing an important role in having opportunities to have an intervention when the person goes to collect their medicines, or request their medicines – the pharmacist can have a conversation with that individual about their using behaviours.”

Ms Burnham-King says that perhaps because of the retail backdrop, community pharmacists may be far less intimidating than doctors to those who are wary of speaking to health professionals in a more formal setting.

“There’s a huge stigma attached to drug users, illegal or legal, that is so counter-productive to having the individual put up their hand for help. A pharmacist fills that space really well, often leading to the individual feeling safer making that disclosure.

“And the pharmacists I’ve spoken to are so keen to be in this space, which is brilliant because so much awareness needs to be created around the risks of using these medicines.

“There are absolutely situations where these medicines are perfect: anxiety, depression, trauma, chronic pain are very serious symptoms, but messages about using them as a short-term solution, and then seeking long-term solutions, sit beautifully with a pharmacist.”

Ms Burnham-King said the Pharmacy Guild’s MedsASSIST program is doing a great deal to combat codeine dependence, particularly in the absence of a national real-time monitoring system for prescription and OTC drugs of concern.

“It’s a great sign that pharmacy wants to be part of the solution.”

Pharmacy Guild of Australia – Victorian Branch president Anthony Tassone told the AJP that since it was rolled out nationally in March 2016, more than five million patient transactions have been recorded in MedsASSIST.

“Approximately 2% of those patient interactions resulted in a denied sale of a codeine-based product, and approximately half of those interactions also resulted in a referral to a doctor for further discussion about their pain management,” Mr Tassone says.

“Real-time monitoring is a useful tool to help make more objective assessments on the clinical appropriateness of a medicine, and the Pharmacy Guild has long supported real-time monitoring for prescription medicines to be implemented as soon as possible.”

He praised the Victorian Health Minister, Jill Hennessy, and the Andrews Government for announcing the development of such a system in the state.

“They’ve committed just under $30 million, not only to establish a real-time prescription monitoring system, but one that was supported by drug addiction counselling and treatment services.

“It’s one thing to identify misuse, but it’s just as important for the health professional workforce to have ways that we can refer patients to receive the necessary treatment and support that they need to help address any drug misuse or abuse concerns.”

Key statistics

  • Deaths from overdose of pharmaceuticals have doubled in a decade, with Australians aged 40 to 49 at greatest risk.
  • More Australians are dying from pharmaceutical overdoses than from all illicit drugs combined. About 70% of prescription deaths were accidental.
  • In Victoria, 358 people died from pharmaceutical overdoses in 2015, compared to 227 from illegal drug overdoses and 257 in road accidents.
  • The greatest increase in pharmaceutical misuse is among men in their 30s and women in their 40s.
  • More than 200,000 Australians are misusing over-the-counter codeine. The majority are well-educated, employed and not illegal drug users.
  • Prescriptions for strong painkillers have increased from half a million in 1992 to 7.5 million in 2012.

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1 Comment

  1. Andrew
    20/02/2017

    Most accessible and visited of all health professionals; purveyors of those agents most responsible for addiction and subsequent morbidity in the community; university trained in pharmacotherapeutics.

    Is there anyone better placed to undertake the desperately needed community D&A work?

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