Politicians from the three major parties have spoken out in support of the role pharmacists can play in reducing harms from licit and illicit drugs
Speaking at the launch of PSA’s new report, Pharmacists in 2023: For patients, for our profession, for Australia’s health system, Health Minister Greg Hunt said that Chronic Pain MedsCheck was “immensely important” and a key tool in battling opioid dependence, misuse and overdose.
“This is immensely important, both in terms of people being able to manage their own pain, but also in dealing with the challenge of opioid addiction,” the Minister told attendees.
“We took some strong steps on the basis of the medical advice… I know that was difficult in relation to codeine, but it brought us into line with the rest of the world and in the end, I think it will have been a very important step.
“But we know that the opioid addiction crisis which, whilst nowhere near the challenge of the United States or elsewhere, could easily get out of hand. It’s already way beyond anything that’s acceptable.
“And so the Chronic Pain MedsCheck is immensely important. 1800 overdose deaths in Australia a year. 1100 of those are from opioids, and 700 of those are from legally obtained opioids.
“What we do on this Chronic Pain MedsCheck will literally save lives and protect lives. And that’s a united front that we have to have.”
He said that the Morrison Government was working with the states on real time monitoring and that he is “very confident” that this will be up and running over the course of this calendar year.
Having a “single national standard of railway gauges, so to speak” in regard to real time monitoring will mean that “somebody won’t be able to shop effectively in Albury, and then slip across the border to Wodonga, whether it’s for opioids, whether it’s for other different medicines so that they become doctor and pharmacist shoppers,” the Minister said.
PSA national president Dr Chris Freeman said that chronic pain, and the misuse of analgesics is a significant problem and said pharmacists needed to be able to do more in this space.
“Chronic pain is a massive issue in this country,” he told the AJP. “The Minister highlighted the substantial problem that the United States have with misuse of opiate prescriptions, and we are headed on a fast track to the same crisis.
“The Society has a strong belief that we need to do more with pain management. But at the same time we also have to try and reduce the risk of harm from those medicines.
“So it’s twofold. Things like real time monitoring are a good example; but alongside that we have to have services to help people who are either addicted, or are misusing those medicines. They are, in themselves, health conditions. And we can’t just identify those people; we’ve actually got to help them.”
Access to services which help people with substance abuse disorders is “completely limited,” he said.
“I’m not suggesting that pharmacists are the answer here – we are part of the solution, but it is clear that people just do not have access to services who are experiencing misuse.
“And I think pharmacists have a critical role in chronic pain management. Chronic Pain MedsChecks is just one example of those services that they could do with that.”
Greens welcome pill testing statement
Also speaking at the launch was Greens national leader and former drug and alcohol doctor Senator Richard Di Natale, who said that the Greens felt pharmacists were underutilised, and that the party wants to do “everything that we can” to ensure that “one of our most highly trained, most respected health professionals” are able to utilise those skills much more broadly.
He said that the key role pharmacists play in harm minimisation strategies such as opioid substitution therapy, syringe exchange programs and providing patients with naloxone is “undervalued” in Australia.
“It’s important to note that we still charge huge out of pocket costs for people to access that treatment, and cost is a barrier,” he said, reiterating the Greens’ commitment to providing $445 million over four years to cover dispensing fees for opioid substitution therapy.
“I note the Victorian branch made this one of their key asks in the Victorian election – good on you for doing that. Thank you again for your advocacy,” he told the Society.
“We’ve costed that proposal; it’s $445 million over the four years.
“Why do we say that for some people, a highly stigmatised group in the community, while we accept that medical care should be subsidised in all of these other areas, when it comes to accessing substitution therapy we make a special case and we make you pay these huge out of pocket costs?
“$440m over four years is a lot of money, but that’s what people are paying now in out of pocket costs.”
Senator Di Natale also praised the PSA for its recently announced position statement on pill testing, in which it supported trials to establish whether such a program could have benefit.
“We need evidence-based policy, and we need people who have an evidence base behind them, and you’re trusted within the public debate to stand up and make their voices heard and you did that,” Senator Di Natale said.
“And I want to congratulate Dr Freeman for your statement, where you said that pill testing informs people of the risks of illicit drugs, without giving the impression that the drugs are safe, that they’re still illegal and potentially harmful.”
Pill testing would not green-light illicit drug use, he said.
“Well, I reckon when you’re telling people, ‘come and get your pill tested, cause if you don’t get it tested it might knock you off, and actually we’re going to test it because this is potentially a very dangerous substance,’ that’s actually a really strong message to be sending people.
“Far from giving people the impression that drugs are safe, it actually gives them the very clear message that these drugs are potentially unsafe. And the intervention itself is really important.
“So thank you for the role that you’ve played. We don’t want to see parents getting that phone call at three or four in the morning when we know we could have prevented that death.”
He said the Greens are committed to harm reduction, and that “This is one of the many ways we’re going to support the PSA in ensuring that you can play the critical role that you play in ensuring that people get access to the care that they need.”
Also speaking was Labor MP and former hospital pharmacist Emma McBride.
She congratulated the PSA on the report and said that “It’s time for action, following this two year consultation process which focused on pharmacists working to their full scope of practice, utilising the training and expertise that they have in the interest of patient care and the Australian health care system, being part of flexible multi-disciplinary teams embedded wherever and whenever medicines are used, and taking greater responsibility and accountability for medication safety.”
Pharmacists have a “razor-like focus” on medication safety and could, and should, have greater responsibility in preventing and reducing the harm which results from misuse, overuse and under-use of medicines.
This will only be possible when pharmacists are part of collaborative teams wherever medicines are used, she said.