Prescribing of ‘powerful’ drug soars

The prescription of strong opioids is continuing to rise in New Zealand with the use of fentanyl more than doubling, despite experts around the world warning of its dangers.

New data from the Health Quality and Safety Commission has shown the number of people prescribed a strong opioid (fentanyl, methadone, morphine, oxycodone or pethidine) at least once in a year had risen from 63,000 people in 2011 to 77,000 last year.

Nationally, almost 17 people in every 1000 received a strong opioid, with most getting morphine (11.2 per 1000). On average 1.8 people in every 1000 people received fentanyl — up from 0.77 in 2011.

Dr Alan Davis, chairman of the Health Quality and Safety Commission’s opioid expert advisory group, warned that while opioids were highly effective in managing certain types of pain, they could also cause harm.

“This might include nausea, constipation, delirium, hypotension, addiction or even potentially life-threatening over-sedation and respiratory depression”.

Fentanyl, an addictive synthetic opioid more than 50 to 100 times as potent as morphine, has become the largest cause of drug deaths in the US. Victims include the pop star Prince.

While the problem may not be as widespread in New Zealand, new figures show no slowdown in the rate strong opioids are being prescribed around the country.

The commission’s figures show 8368 people were prescribed fentanyl last year with the figures steadily trending up from 3410 people in 2011.

Of the more than 8000 people prescribed fentanyl in 2016, almost 2000 received it for six weeks or more.

For the past three years, the prescription rate for fentanyl has been highest in the Whanganui District Health Board, followed by the Bay of Plenty then Capital and Coast.

In Whanganui last year, the rate of fentanyl prescriptions was 5.2 per 1000 people — almost triple the national average.

Executive director of the Drug Addiction Practitioners’ Association of Aotearoa-New Zealand Sue Paton said the increase in the rate opioids were being prescribed was a concern, especially with drugs like fentanyl.

She believed the amount of opioid abuse in New Zealand was probably underestimated and put the number of addicts at about 50,000.

She said the increase in fentanyl use was of particular concern.

“Fentanyl is a very powerful drug; it’s quite easy to overdose on. It’s certainly a drug we should be wary of.”