Prescription painkillers kill more than heroin


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The Guild has called again for real time monitoring after data show prescription painkiller overdose deaths have overtaken those from heroin

The rate of accidental deaths due to opioids is increasing and has more than doubled among Australians aged 35 to 44 since 2007, with more than two-thirds of the deaths due to pharmaceutical opioids rather than heroin, a report from the National Drug and Alcohol Research Centre has found.

The report analyses cause of death data from the Australian Bureau of Statistics and found that in 2013, the last year for which finalised data is available, 597 Australians between the ages of 15 and 54 died from accidental overdose of opioid.

70% of these deaths were due to opioids other than heroin, including strong prescription painkillers.

Initial estimates for 2014 and 2015 indicate that the number of accidental opioid deaths is continuing to increase, NDARC says.

In a reversal of the heroin epidemic of the late 90s and early 2000s, when heroin deaths peaked at over one thousand, the 2013 figures show that accidental death related to opioid overdose is more likely to affect older Australians– those aged 35 to 44 and those aged 45 to 54.

Deaths among 45 to 54 year olds are now higher than at the peak of the heroin epidemic in 2001; by contrast deaths among 15 to 24 years olds remain low and deaths among 25 to 34 year olds have declined since 2011.

The Pharmacy Guild said in a statement today that the data, which was reported by Fairfax Media, reinforces the urgent need for a nationally consistent mandated system for real time recording of controlled drugs.

The Guild says it strongly supports the introduction of real time recording, and the urgency is highlighted by today’s reporting of the data.

It says that for too long, coroners around the nation have sounded the alarm on these overdose deaths and called for a national system of real time recording, with no national system implemented.

The Federal Minister for Health, Greg Hunt, recently committed to progressing the issue, and the Guild says it strongly supports any measures the Commonwealth, State and Territory governments can take to bring the long awaited clinical support tool into operation nationally.

Real time recording is a vital clinical tool which would enable doctors and pharmacists to identify and support patients with prescription drug addiction issues, it says.

The President of the Guild’s Victorian Branch, Anthony Tassone, said: “Doctors and pharmacists should not be expected to continue working at the front line tackling the prescription drug dependence issue without the full knowledge that real time recording would provide.

“As we have been doing consistently for a number of years, the Guild will continue advocating and working with other health professionals, patient and family groups, and governments until this long overdue gap in the health system is addressed,” Mr Tassone said.

It says that while MedASSIST had been taken up voluntarily—and continues to be used—by more than 70% of community pharmacies nationally, but such systems need to be mandatory.

Currently, there is no national real time recording and monitoring system used by doctors to provide information on patients that might be misusing prescription codeine medicines (or other prescription medicines) by doctor shopping, the Guild points out.

With the proposed upscheduling of low-dose medicines containing codeine to prescription-only, there is currently little or no ability for GP prescribers to know if a patient who asks for codeine has not had the same medicine recently prescribed to them by another doctor. 

This is why a nationally consistent real time recording system must be implemented urgently, the Guild says.

Key findings from the NDARC report:

  • There were a total of 597 accidental opioid overdose deaths in 2013 (564 in 2012) among those aged 15 to 54 years, and 668 deaths across all ages (639 in 2012).
  • In 2013, the rate of accidental overdose deaths due to opioids in Australia was 46.7 per million persons aged 15 to 54 years, compared to 44.7 per million persons in 2012. Among all ages the rate of accidental opioid deaths in 2013 was 28.9 per million persons (28.1 in 2012).
  • In 2013, 189 (32%) of the 597 accidental opioid deaths among Australians aged 15 to 54 were due to heroin (30% in 2012 were due to heroin). Among all ages, 198 (30%) of the 668 deaths were due to heroin (data not shown).
  • In 2013, 408 (68%) of the 597 accidental opioid deaths among Australians aged 15 to 54 were due to pharmaceutical opioids (70% in 2012 were due to pharmaceutical opioids). Among all ages, 470 (70%) of the 668 deaths were due to pharmaceutical opioids.
  • In 2013 among Australians aged 15 to 54, approximately one-third (32%) of the accidental opioid deaths occurred in New South Wales (NSW) (n=190), 28% in Victoria (VIC) (n=166) and 19% in Queensland (QLD) (n=114). NSW and VIC recorded an increase in accidental opioid deaths in 2013, with QLD, SA and WA recording a decline. In the smaller jurisdictions (Tasmania (TAS), the Northern Territory (NT) and the Australian Capital Territory (ACT), deaths are small in number.
  • Projected estimates for 2014 (n=684) and 2015 (n=689) suggest that accidental opioid deaths are trending upwards among those aged 15 to 54 years. These figures should be interpreted with caution as they are estimates and may change.

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