There may be a slightly potent killer in our midst that some of us may scoff at or choose to ignore. Prescription drugs such as codeine and oxycontin have been aggressively pushed in communities around the globe with catastrophic and devastating effects on small communities. There are those who claim that these effects are reverberating through to larger cities contributing to an epidemic of wider and more potent drug use and creating an addiction/dependency crisis on a national level.
The Opioid Epidemic as it is being called is perhaps more prominent in American cities where aggressive marketing and administration of opioid medications have seen whole counties reduced to ghost towns after they were blanketed with opioids from pharmaceutical companies. Law suits have been filed and a growing movement of persons seeking action on large scale pharmaceutical companies (aided and abetted by doctors and pharmacists) is spreading through more high profile cities and movements on streets of larger cities such as Washington DC, San Francisco and New York.
People like Nan Goldin in New York are garnering supporters and aiming their vitriole at large scale pharmaceutical companies(such as the Sackler Family - a vastly wealthy family empire that has made millions off the administration of prescription medication) as the culprits of a national addiction/dependency crisis that is causing widespread drug abuse issues across the country.
But what of Australia? Whilst much fo the focus of the Opioid Epidemic is focused on American cities and states, surely Australia is not following the same path? Think again… Australia is experiencing similar rises in rates of opioid prescriptions of some 15 fold since 2010 and death rates from opioid related dependence is increasing at alarming rates. New data from the National Coronial Information System states that from 2010 - 2016, opioid death rates have skyrocketed and in 2016, opioids killed more people than the National Road Toll.
The similarities between the Australian rates of prescribed medication of opioids and cases of addiction/dependence with ‘doctor shopping’ and associated recreational drug use of substances such as Fentanyl are alarming similar to the example of smaller American cities. In an ABC report on Foreign Correspondent Opioid America, Conor Duffy exposes the links between hard drug users on the streets of San Francisco and the experience of a small West Virginian county that had 12 million Oxycontin Pills flooded into a community of 20,000 people. People in smaller communities are being addicted to opioids and when restrictions are finally put in place, they seek out harsher substances such as Ice, heroin and Fentanyl, spiralling into hard drug use and addiction. In Duffy’s article he cites there are more drug users in San Francisco (25,000) than there are high school students. And of these hard drug users, 80% of them started on opioid medications.
The links between opioid medication used as pain relief and hard drugs is being brought to light by journalists such as Ben Westhoff who went undercover to investigate and infiltrate a drug ring based in China in his exposé Fentanyl Inc. Westhoff exposes how Fentanyl has become the new synthetic drug that is changing the landscape in the recreational drug world and how rogue chemists are creating a deadly new generation of Novel Psychoative Substances. Through addiction, mislabeling, purposefully and mistakenly mixing drugs, rogue chemists are leading a social epidemic that is having tragic consequences on a global scale.
Oxycontin, Endone, Tramadol, even Panadeine Forte are all accessible opioid medications, prescribed for pain relief, administered by doctors and pharmacists for a myriad of conditions. There are those that genuinely need these medications, however the misuse of these medication coupled with their addictive and potentially harmful qualities are creating an uneasy situation in communities in Australia that mirrors the US experience. According to an article Australia’s Opioid Crisis by Farrah Tomazin in the The Age (pub 4 Feb, 2020) Australia has the 8th highest opioid consumption rate in the world. Tomazin also claims that this social issue is helped in no small part by pharmaceutical companies aggressively marketing opioid products to doctors for pain relief.
Mundipharma Australia - an affiliate of US-based OxyContin maker Purdue Pharma and other pharmaceutical companies such as Sanofi, Pfizer and Janssen Global Services have been actively canvassing and promoting their products in similar aggressive marketing that mirrors the American experience. Lavish conferences, product launches, seminars and masterclasses are all part of the campaigns to promote the courting of pharmacists and doctors in the promotion of these products. The Sackler family, owners of Purdue Pharma are currently facing law suits in America from communities affected by the overprescription of opioid medications in the US.
Individual cases of addicts using over the counter prescription medications are common in Australia. We may think these products are harmless but the reality is starkly different when you read about a Victorian man, given 58 prescriptions for 1500 OxyContin tablets and a further 29 scripts for diazepam, a dangerous benzodiazepine used for anxiety, in the months before his death from an overdose. This is the grass level roots of addiction issues and this is where responsibility has to be taken to prevent addictions from being the widespread norm as we are seeing in the US example.
There is a call for Government intervention via a National Registration system that monitors prescription use and is widely transparent to anyone in the line of drug administration such as GP’s and pharmacists. Such a scheme exists in Victoria where a register records a persons individual drug prescription history to monitor repeat prescriptions and overall drug use tracking. This has been promised on a national level and even been pledged 16 million dollars but the Federal Government however the appearance of a National Register is yet to exist with Federal Health Minister Greg Hunt calling on states and territories to integrate systems on a National Data Register. There is still no National Register.
There are some that say it is not just down to the drug companies but the doctors and pharmacists themselves. There is some claim that Australia’s medical system ‘incentivises’ quick fix consultations where not enough investigation goes into a patients complaints and this results in poor assessment and untrained decisions on pain management that result in drug prescription, particularly in rural areas. In a report from the UNSW National Drug and Research Centre published in 2019, Dr Gabrielle Campbell talks about the lack of multidisciplinary services being available to combat the opioid use in Australia. This includes psychological approaches and physical therapies being used to work with medications in relation to pain relief. Dr Campbell states that “few non-medical services are funded by Medicare in the community, and hence out-of-reach for the majority of patients requiring their assistance” . She goes on to cite that there is an inability to access other options for pain management and associated addiction abuse in the national framework and that national benchmarks for quality pain and addiction services are not lacking in local health networks. In short, people aren’t getting access to any alternatives other than medication.
Investigating forms of pain management that are appropriate and cross disciplinary modalities such as Naturopathy, physical therapies such as Bowen technique and yoga - all modalities that have been removed from the Health Rebate Scheme in 2019 under direction of the Federal Government reviews are exactly the sort of multidisciplinary approaches that can perhaps help with this kind of base level pain management. The adage of ‘going to the doctor for advice and being given two panadol and told to come back in the morning’ no longer cuts the mustard in the current opioid crisis climate. Perhaps also we need to take personal responsibility and make better choices in choosing the types of practitioners that we use for our pain management systems and who we should be listening to in our daily search and interactions with health concerns and pain management.
If you believe you know of someone who may have an issue with Opioid dependence/addiction then please visit the TURN TO HELP website for more information and assistance with assessing this problem.
