DESPITE an 11-fold increase in the number of patients prescribed strong opioids over the past 3 decades, Australia has no comprehensive, coordinated approach to overdose prevention by national and state governments and professional groups, according to the authors of an editorial published today by the Medical Journal of Australia.
Professor Adrian Dunlop, Director of Drug and Alcohol Clinical Services at the Hunter New England Local Health District, and colleagues wrote that “the marked increase in the total number of patients prescribed opioids is driving an increase in the number of opioid-related deaths”.
“Nevertheless, concerns about opioid-related harms are not at the same level in Australia as in North America. Restrictions on direct advertising of pharmaceuticals to patients, as well as regulatory and professional actions, have resulted in different patterns of prescribing and outcomes in Australia. However, the harms associated with non-medical opioid use could also increase in Australia.
“There has been no comprehensive and coordinated approach to overdose prevention by national and state governments and professional groups,” Dunlop and colleagues wrote.
“Providing safe and effective treatment for patients with chronic pain is of fundamental importance.
“Opioid medications are only one approach, but they are overused because of limited access to multidisciplinary services incorporating evidence-based interventions, including psychological and physical therapies.”
Dunlop and colleagues concluded that a number of different approaches was needed, preferably coordinated at the national level.
“We need a combination of strategies, including improving the uptake of take home naloxone, real time prescription monitoring, regulatory changes, better access to specialist multidisciplinary services, and education for health professionals and the general public,” they said.
“Importantly, these strategies should be coordinated within a national overdose avoidance strategy.
“Our health system is struggling to adequately respond to the increasing number of patients with complex chronic pain together with mental health and addiction conditions.
“Relying on GPs without adequate support from specialist services contributes to excessive use of interventions that can be delivered in short general practice consultations: driving a marked increase in opioid prescribing and the consequent harms.
- Cate Swannell