Prescription drug deaths soar

hospital staff wheel away empty gurney

Drug-induced deaths are at their highest rate since the late ’90s, new data from the ABS shows – but the profile of such deaths is very different

“There were 1,808 drug induced deaths in 2016, with those deaths most commonly associated with benzodiazepines and oxycodone,” James Eynstone-Hinkins, Director of Health and Vital Statistics at the ABS says.

“These are both prescription drugs which are used to manage anxiety and pain respectively.”

The ABS’ new report shows that there were 158,504 deaths in Australia in 2016, with a corresponding standardised death rate of 5.4 per 1,000 people.

The figure of 1,808 drug-induced deaths last year is the highest number of drug deaths in 20 years, similar to the number recorded in the late 1990s.

While the figure is similar, the picture of drug-induced deaths looks very different, however.

In 1999, a person who died from a drug-induced death was most likely to be younger (early 30s) with morphine, heroin or benzodiazepines detected on toxicology at death.

In 2016, a person dying from a drug-induced death was most likely to be a middle-aged man, living outside a capital city, who is misusing prescription drugs such as benzodiazepines or oxycodone in a polypharmacy setting. The death was most likely to be an accident.

After drug-induced deaths peaked in the late 90s, rates were relatively stable in the early to mid-2000s.

However the ABS has recorded a significant increase in drug-induced deaths from 2011, with a preliminary rate of 7.5 deaths per 100,000 people recorded in 2016.

The majority of drug-induced deaths in 2016 were due to acute accidental overdoses (71.3%), followed by suicidal overdoses (22.7%). Other types of drug deaths, including addictions and chronic complications of drug abuse as well as homicide and undetermined intent accounted for the remaining 6%.

More than half (59%) of all acute drug deaths had two or more substances identified on the toxicology report at death.

The most common class of drugs identified in these reports was opioids, which have been the leading class of drug implicated for the last 20 years. However, all classes of drugs have reported a higher rate of presence in drug deaths per 100,000 persons when compared with 1999, and there has been a rise in deaths associated with stimulants since 2011.

When analysed by single drug type, benzodiazepines were the most common substance present in drug induced deaths in 2016, being identified in 663 (36.7%) deaths.

Perceptions of drug deaths in the community are somewhat different, however: the ABS cites AIHW data from 2016 which shows that methamphetamines (including ice) were the drug class causing most concern in communities.

There was a misperception that these drugs caused the most drug deaths (excluding tobacco and alcohol).

While prescription drugs actually cause the highest numbers of drug induced deaths, there has been a rapid increase in the number of methamphetamine deaths, with the death rate in 2016 four times that in 1999 (1.6 deaths compared to 0.4 deaths per 100,00 persons respectively).

They are now the third most common substances associated with drug deaths, with heroin being the fourth most common.


Other causes of death

Australia’s leading cause of death continues to be heart disease, although the number and rate of death from heart disease continues to decline.

As death rates from heart disease and stroke decrease, other diseases such as dementia, which includes Alzheimer’s disease, continue to increase.

“In 2016, dementia became the leading cause of death among Australian women,” Mr Eynstone-Hinkins says.

“Improvements in treatments and prevention of heart disease have contributed to increased life expectancy, but this has also led to increased deaths from conditions such as dementia which affect predominantly very elderly Australians.”

Alzheimer’s Australia Chief Executive Officer Maree McCabe said it was disappointing to see that dementia was now the leading cause of death in women in Australia and that the overall rates for dementia were increasing.

“This fact combined with the increasing prevalence of dementia is surely a cause of concern for all Australians,” she said.

“As a nation we need to do more to reduce people’s risk of dementia so that the onset of dementia in individuals is avoided or delayed, resulting in fewer people in the community having dementia.

“While it is heartening to see that less Australian women are dying from heart disease due to better treatment options and support, there is still no cure for dementia and people with dementia still struggle to find appropriate support and services.

“More than ever we need to focus on solutions that will meet the specific needs of people living with dementia and their carers and families.

“This includes a multipronged strategy that can reduce the risk and prevalence of dementia, while still building capacity within our communities to understand the needs of people with dementia, and giving people with dementia and their family and carers the specialised support they need in navigating our complex health system.”

Cancers accounted for almost 30% of Australian deaths in 2016. Lung cancer accounted for the most cancer deaths, making it the second leading cause of death for males and fourth leading cause overall.

Colorectal cancer was the sixth leading cause of death, accounting for 5,462 deaths in 2016. Breast cancer was the sixth ranked cause for women, while prostate cancer was the sixth ranked for men.

Diabetes is Australia’s seventh leading cause of death overall, accounting for 3% of all deaths in 2016. Diabetes was considered to be a contributory factor in 10.4% of all deaths in 2016.

Suicide is the leading cause of death among people 15-44 years of age and remains the leading cause of premature mortality in Australia. In 2016, suicide deaths occurred at a rate of 11.7 deaths per 100,000 people.

Aboriginal and Torres Strait Islander peoples are approximately twice as likely to die by suicide than non-Indigenous Australians, with 162 Aboriginal and Torres Strait Islanders dying by suicide in 2016.

Suicide Prevention Australia Chief Executive Sue Murray called for those working in suicide prevention to hold their focus: “Suicide is a complex public health issue that requires sustained investment in prevention efforts to support more Australians to live.

“We are encouraged by the reported decrease, increased funding, support across Parliament and focus on regionally driven suicide prevention over the past year.

 “Many organisations and communities are working hard to implement locally driven prevention plans focusing on priority issues such as primary care and care following discharge from our hospitals, as well as trialling innovative whole of community solutions.

“We will continue to encourage all working in suicide prevention to hold their focus on making the deep systemic and social changes needed.”

The infant mortality rate is at a record low of 3.1 deaths per 1,000 live births.

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