Almost 2m Australians start taking opioids every year

Researchers from Monash University’s Centre for Medicine Use and Safety (CMUS) have found that a staggering 1.9 million Australian adults begin taking prescription opioids every year — a worrying trend that suggests the USA’s so-called ‘opioid epidemic’ has made its way down under.

Led by CMUS PhD candidate Samanta Lalic (also a pharmacist at Austin Health), researchers analysed the dispensing of opioids through Australia’s Pharmaceutical Benefits Scheme (PBS) from 2013 to 2017. The results were published in the British Journal of Clinical Pharmacology.

The research not only reveals just how many Australians are being dispensed opioids, it also finds that 2.6% of them — or around 50,000 people — become long-term users over a year. Furthermore, an increasing proportion of patients are being started on stronger opioids.

This is where the real cause for concern lies, according to Lalic, because both long-term use and the use of strong opioids are associated with a range of adverse health outcomes. High-dose opioid use has been associated with falls, fractures, hospitalisations and motor vehicle accidents — not to mention death from overdose. The Australian Institute of Health and Welfare (AIHW) recently revealed that overdose from prescription medicines has overtaken road deaths and illicit drug overdose as a cause of death in Australia, with deaths involving opioids nearly doubling in the last 10 years.

“Opioids do have an important role in managing cancer pain and acute non-cancer pain; however, their use remains less well established for chronic — ie, long-term — non-cancer pain,” Lalic said.

“For the treatment of chronic pain, we need to change prescribing culture and raise the level of awareness of other treatment options among patients. The goal of care, treatment expectations and intended duration should be agreed upon by patients and prescribers prior to opioid initiation.

“In many cases the safest and most effective way to treat chronic pain will involve a combination of therapies, including exercise, physiotherapy and non-opioid painkillers.”

Lalic said the next step is to determine how prescribers and patients escalate doses over time. This is important, she said, “because international research has demonstrated a strong link between prescribed dose and overdose deaths”.

Australia’s Therapeutic Goods Administration (TGA) released a consultation paper earlier this year inviting comments on options for a regulatory response to the potential misuse of prescribed opioids in Australia. These submissions and planned next steps can be viewed on the TGA website.

Image credit: ©stock.adobe.com/au/Jason