The drug crisis stalking older Australians

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Governments must wake up to the crisis of unintentional overdose deaths, with older Australians increasingly at risk, says the nation’s leading independent drug policy organisation, the Penington Institute.

New figures show that Australians aged 50-plus accounted for more than 40 per cent of all unintentional overdose deaths in 2018.

Australia’s Annual Overdose Report 2020 shows that 2070 Australians died of overdose in 2018, the fifth consecutive year with more than 2000 deaths.

“This is a crisis. And what’s worse is these deaths are preventable,” says Mr John Ryan, CEO of the Penington Institute. “We simply can’t accept, nor should we, that 2000 sons and daughters, mums and dads, and brothers and sisters die every year from a drug overdose.

“Concerted campaigning, investment in evidence-based policies and community education has done a great job of bringing down the road toll. We must tackle our overdose crisis in the same way.”

Opioids continue to be the drug type most commonly associated with overdose deaths, with 900 Australians losing their lives due to unintentional opioid-related overdoses in 2018.

Unintentional overdose deaths occur at higher rates in rural and regional Australia. There were 7.3 unintentional overdose deaths per 100,000 people in rural and regional areas, compared with 5.8 per 100,000 in the capital cities in 2018. 

“We want Australia’s Annual Overdose Report to encourage Australians from all walks of life to talk more about overdose and drug issues,” says Mr Ryan. “That’s vital if we’re to bring this hidden crisis out of the shadows.

“The rich, middle and poor are all impacted by overdose. City and country, too. It is not someone else’s problem. It is an Australian problem that we must collectively face up to.”

The report was released today on International Overdose Awareness Day, which aims to reduce stigma surrounding drug-related deaths and help people identify and respond to signs of an overdose.

The report also found that unintentional overdose deaths involving four or more substances – often referred to as polydrug use or polypharmacy – continued to escalate. Numbers had almost quadrupled from 163 in 2013 to 582 in 2018.

The Royal Australian College of General Practitioners (RACGP) acknowledges that opioids remain the main cause of accidental overdose death in Australia.

“Opioid-related deaths hovered at around 450 per year at the turn of the century, but these numbers have risen sharply since 2006 to hit over 1100 per year since 2014.”

It says that in the late 1990s, prescription opioids seemed like an “ideal answer” to chronic, non-malignant pain.

“There was an increased demand to treat chronic pain. There were very few options and very little research that had been done on this problem,” says opioid expert Dr Evan Ackermann.

“This was mixed with a situation of some fairly aggressive drug company marketing of opioids and a change of clinical attitude towards pain. Normally, pain would be part of the healing process, but people started to say we should be looking at pain as the ‘fifth sign’ and treating it aggressively.

“It was a cultural shift across the healthcare sector, across the board, from pharmacy right through to general practice, specialists and hospitals.”

Associate Professor Mark Morgan, chair of the RACGP Expert Committee – Quality Care (REC–QC), told newsGP that prescribing of opiods should include a plan for de-prescribing.

“There needs to be a cultural shift away from the use of opioids for most chronic non-cancer pain because there are enormous personal risks, identifiable harms and societal costs from having such high levels of use,” he said.

“Before starting, and at each review of opioid prescriptions, there should be a careful weighing up of pros and cons. This should include a discussion with the patient about the potential harms and risks, and realistic expectations from using the medication.

“Prescribing for acute nociceptive pain – for example, after an injury or surgery – should be for just a few days with close review. Smaller pack sizes will help this shift.”

Dr Simon Holliday, a GP with a special interest in pain management, says opioids are ‘cure-alls’. “We all feel great when we use these drugs and they relieve our symptoms. But the problem is, it’s all short term and we now know that our problems will come back worse if we take this approach.”

The Australian Institute of Health and Welfare (AIHW) reports that in 2018, opioids were present in nearly two-thirds of drug-induced deaths (64.5 per cent or 1123 deaths) – a rate of 4.6 per 100,000 people. Eighty per cent of opioid-induced deaths were accidental.

“Over the past decade, drug-induced deaths were more likely to be due to prescription drugs than illegal drugs, and there has been a substantial rise in the number of deaths with a prescription drug present,” the AIHW report states.

Safe opioid use
Opioids are drugs used to treat moderate to severe pain. Common prescription opioids include oxycodone, hydrocodone, morphine and methadone. Fentanyl is a synthetic opioid approved to relieve severe pain.

Older adults are more likely to suffer from chronic pain and physical illnesses making them more susceptible to the addictive properties of prescription opioids.

  • Take pain relievers only as directed. If you are taking opioid pain relievers, be sure to tell your doctor about all other medicines you are taking because some medicines, when taken together with pain relievers, can cause an overdose.
  • Never take opioids in greater amounts or frequency than prescribed
  • Don’t sell or share opioids
  • Store opioids in a safe place, where others can’t access them
  • Properly dispose of unused opioids
  • Keep a list of your medicines
  • Follow directions
  • Ask questions
  • Keep up with any blood testing recommended by your doctor.

Signs of an opioid overdose

  • constricted pupils
  • loss of consciousness
  • laboured breathing
  • choking or gurgling sounds
  • limp body
  • pale, blue, or cold skin.

Do you feel fully informed about the dangers of prescription medications? Do you take multiple drugs?

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Written by Will Brodie

12 Comments

Total Comments: 12
  1. 0
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    I refuse to take any because I focus on eating well, exercising and keeping healthy. It is increasingly obvious that the bottom line is we are getting more dependent on drugs to manage everything and not enough on prevention. Doctors seem to be pushing us more and more onto tablets. The limit came for me when a doctor suggested I started to take something just in case. Is it any wonder why when billions of dollars profit are at stake!

    • 0
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      I agree with you, Ted Wards, the side effects of most prescription drugs are horrendous, worse than the complaint.

    • 0
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      It’s very clear that you have not suffered from chronic debilitating pain. There are many of us who have lived healthy active lives who in our later years, generally, are afflicted with crippling inherited conditions, or who as a result of surgery, are left with chronic pain.
      Pain specialists introduce sufferers to a number of services: physiotherapy, psychology (no shame ever if you need help) because it certainly is depressing to suffer chronic pain, support groups etc.
      All doctors will get you to try a number of non addictive medications in preference to opiates.
      They may introduce you to a number of interventions such as spinal stimulators.
      Sadly some people still only get significant relief from opiates.
      There are none who would rather not have these drugs such are the side effects, one of which is horrific constipation.

    • 0
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      I agree with you Maggie. When you suffer chronic pain and discomfort you really don’t have a choice. I admit to being someone who has to take a cocktail of tablets just to get by. I certainly try and limit the number of opiates I take but if I didn’t have the tablets, I wouldn’t sleep at all, I wouldn’t function during the day and I’d be suffering with pain constantly. The tablets don’t stop the pain or fix the problems I have but they make it easier to manage. I’ve had every test in the book and Doctors, Neuro’s, alternative therapists all agree it’s my only option and I will only get worse. I believe I eat well enough and get heaps of exercise (although the more I do the more I pay the price for it) but I think if you’re genetically blessed, count yourself very lucky. I try and assist my condition with acupuncture and chiropractic treatments but even with private health cover it eats into the DSP. I have had a couple of prescription med’s that I’ve refused to take because their side effects were dreadful and I don’t believe they should even be on the market. Also some people will take whatever they can lay their hands on and no restrictions will stop them. They’ll always find a way

    • 0
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      Ted and Triss Typical useless blatherskite comment.
      If you can not say something useful please don’t say anything.

  2. 0
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    TED WARDS I can see that you have never had full body nerve pain in your life! There is a lot of people out the that do!

  3. 0
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    How do they know the deaths are unintentional? Because our crap government refuse to bring in euthanasia a lot of people in chronic pain or poor health, sadly, have to do it themselves.
    I very much doubt all those deaths are unintentional.

    • 0
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      I agree Snowflake. When I read ‘unintentional’ I wondered how they could possibly know what the intentions of the deceased were?
      Without legal voluntary euthanasia, no one taking the overdose option dares to involve family or friends who might be arrested for being complicit in the death.
      I notice however some interesting statistics in a later paragraph. ie: that two thirds of drug induced deaths were opioid based. That means that one third – a substantial amount – were based on non opioid drugs. The same para referred to 80 percent of the opioid deaths being accidental, which seems to be an acknowledgement that around 20 percent were deliberate.

  4. 0
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    In 2012 I suffered a life-threatening illness which entailed a lot of pain. To get me in the ambulance the Ambos gave me a shot of morphine and in hospital I was also given morphine. Morphine is a wonderful drug ,takes you from excruciating pain to floating on cloud 9 in a few minutes. I can understand why some people can get addicted to it. I was in hospital for about 6 weeks and had many morphine injections, usually in the early hours of the morning when the pain was at its worst (why is pain worse at night than during the day?). Post hospital I was prescribed a narcotic (Endone I recall) as a prn, ie take as required, under close supervision of my resident nurse, ie my wife. Used properly drugs, even addictive ones, can be so beneficial.

  5. 0
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    And so how many people died of opioid medications since they were made prescription only? Wasn’t that the excuse that was made when removing them from over the counter sale?

    Frankly, if people are going to overdose they will do so. People die for all sorts of reasons e.g. car crashes but we don’t immediately ban the thing that causes the death! Meanwhile the majority of people using opioid medications (either prescribed or OTC) use them responsibly.

    I am also in favour ofhaving more than just a prescription for dealing with chronic pain and a number of different approaches should be tried both individually and in combination. But that doesn’t negate the use of medications when warranted.

  6. 0
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    I also ate well all my life was extremely fit and active and a member of the special forces in the UK,but I take opioids and am thankful for them. When your legs are gone thanks to an IED nearly 30 years ago but you still get searing unbearable pain in the legs that are gone you are thankful for opioids. To people who say the cure is worse than the disease I say you are very lucky not to suffer the way others do.

    • 0
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      So true Returned Serviceman. I have to say too, even though it was in the UK, thanks for your service. In my opinion and that of others I’ve spoken to, those who never seem to get sick or don’t suffer pain often can’t cope with those who do. It’s so foreign to them that someone can’t do what they do, can’t keep up, complains of pain and not feeling well. It’s almost as though they think you’re putting it on, or that it makes them uncomfortable.


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