PRE­SCRIP­TION opi­oid drug de­pen­dency in South Aus­tralia has reached “epi­demic” pro­por­tions, killing the same num­ber of people as il­licit drugs such as heroin and metham­phetamine.

The state’s peak med­i­cal body says the problem is es­ca­lat­ing year on year and is now so harm­ful that it needs sim­i­lar pub­lic safety aware­ness as SA’s hor­rific road toll.

Pre­scribed opi­oids, such as oxy­codone and fen­tanyl, are used to treat mod­er­ate to se­vere pain, are highly ad­dic­tive and can be fa­tal be­cause they cause drowsi­ness and slow breath­ing.

The Aus­tralian Med­i­cal Associatio­n in SA says doc­tors in the north­ern and south­ern re­gions of Ade­laide have re­ported a five-fold in­crease in pa­tients re­quir­ing treat­ment for opi­oid de­pen­dence over the past decade.

“There is a mas­sive, silent epi­demic hap­pen­ing right now that, in some ways, is as se­vere and harm­ful to the com­mu­nity as do­mes­tic vi­o­lence, gam­bling, road fa­tal­i­ties and il­licit drugs – it just hasn’t had the same aware­ness,” AMA (SA) pres­i­dent Dr Chris Moy said.

He said that for ev­ery South Aus­tralian who recog­nised they had an opi­oid de­pen­dency problem, there were many more who did not and were in dan­ger of se­ri­ous side­ef­fects and in­creased risk of death.

“Those we know of are the tip of the ice­berg and, be­cause th­ese pa­tients have be­come phys­i­cally and psy­cho­log­i­cally ad­dicted to the eu­phoric feel­ing – the ‘hit’ – of opi­oids in the course of us­ing th­ese med­i­ca­tions for pain man­age­ment, they are play­ing games with their own lives.

“Some­thing needs to be done im­me­di­ately to address this hid­den pub­lic health is­sue that is grow­ing in mag­ni­tude.”

Lat­est data from the 2019 Pen­ning­ton In­sti­tute Aus­tralia’s An­nual Over­dose Re­port shows 121 South Aus­tralians died from pre­scrip­tion opi­oids from 2013 to 2017 – the same num­ber as those killed us­ing il­licit drugs over the same pe­riod.

The re­port says ac­ci­den­tal phar­ma­ceu­ti­cal opi­oid deaths in SA jumped 63 per cent from

2003-07 to 2013-17. The num­ber of South Aus­tralians treated for opi­oid de­pen­dency is also ris­ing – to 3143 last year, up from 1839 a decade ago.

And the se­cond-high­est re­gion in Aus­tralia for opi­oid dis­pens­ing is the Play­ford area, in the north­ern sub­urbs. the lat­est Aus­tralian In­sti­tute of Health and Wel­fare re­port says.

Pain medicine spe­cial­ists such as Dr Mered­ith Craigie said it could take a long time, some­times years, for phar­ma­ceu­ti­cal opi­oid-de­pen­dent users to recog­nise they had a de­pen­dency problem, and even longer to im­ple­ment a pain­man­age­ment strat­egy that helped them over­come their de­pen­dency and man­age their pain.

“It be­comes a vi­cious cir­cle and people just don’t know how to get off,” said Dr Craigie, dean of pain medicine for the Aus­tralian and New Zealand Col­lege of Anaes­thetists.

She said de­bil­i­tat­ing and life-chang­ing side-ef­fects from pro­longed use of opi­oids in­cluded im­mune-sys­tem sup­pres­sion, cog­ni­tive im­pair­ment – in­clud­ing mem­ory loss and com­pro­mised de­ci­sion-mak­ing – and de­pres­sion.

Dr Craigie said doc­tors of­ten strug­gled to con­vince pa­tients they needed to re­duce dan­ger­ous doses and that a multi-dis­ci­plinary ap­proach in­volv­ing pain spe­cial­ists, nu­tri­tion­ists, psy­chol­o­gists and phys­io­ther­a­pists was needed.

“There is a grow­ing moral im­per­a­tive to treat chronic pain in a more hu­mane way, but opi­oids alone are not the so­lu­tion,” she said.

The Aus­tralian and New Zealand Col­lege of Anaes­thetists and the AMA (SA) are among 16 or­gan­i­sa­tions be­hind an SA-first com­mu­nity cam­paign run by Re­turnToWork­SA to com­bat the grow­ing im­pact of opi­oid mis­use and overuse.

The cam­paign, called ReachForTh­eFacts, has de­vel­oped a search­able data­base for South Aus­tralians to check whether their med­i­ca­tions are opi­oids, a screen­ing tool to help de­ter­mine whether de­pen­dence is present, and re­sources for GPs and health pro­fes­sion­als to help pa­tients with pain man­age­ment.

The State Gov­ern­ment said a real-time no­ti­fi­ca­tion sys­tem for doc­tors and phar­ma­cists to address doc­tor-shop­ping would be rolled out in stages from next year to help re­duce the ris­ing toll of phar­ma­ceu­ti­cal drug mis­use. FOR MORE IN­FOR­MA­TION, VISIT REACHFORTH­EFACTS.COM.AU. IF YOU OR SOME­ONE YOU KNOW NEEDS HELP, CALL LIFE­LINE 13 11 14 OR BEYOND BLUE 1300 224 636.

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