Now Australia faces its own opioid crisis after warnings ignored
Half a world away from the opioid epidemic ravaging the United States, Australia is facing a crisis of its own, with skyrocketing rates of opioid prescriptions and related deaths.
The country has failed to heed the lessons of the U.S., and has been slow to respond to years of warnings from worried health experts. The crisis comes as drug companies — facing scrutiny for their aggressive marketing of opioids in America — have turned their focus abroad, working around marketing regulations to push the painkillers in other countries.
In dozens of interviews, doctors, researchers and Australians whose lives have been upended by opioids described a plight that now stretches from coast to coast. Australia’s death rate from opioids has more than doubled in just over a decade. And health experts worry that without urgent action, Australia is on track for an even steeper spike in deaths like those in America, where the epidemic has left 400,000 dead.
“It’s depressing at times to see how we, as practitioners, literally messed up our communities,” said Dr. Bastian Seidel, who warned that Australia’s opioid problem was a “national emergency” two years ago when he was president of the Royal Australian College of General Practitioners. “It’s our signature on the scripts.”
He sees Australia moving with willful ignorance toward a disaster.
“Unfortunately, in Australia, we’ve followed the bad example of the U.S.,” he says. “And now we have the same problem.”
Starting in 2000, Australia began approving and subsidizing certain opioids for use in chronic, noncancer pain. Those approvals coincided with a spike in opioid consumption, which nearly quadrupled between 1990 and 2014, says Sydney University researcher Emily Karanges.
As opioid prescriptions rose, so did fatal overdoses. Opioid-related deaths jumped from 439 in 2006 to 1,119 in 2016 — a rise of 2.2 to 4.7 deaths per 100,000 people, according to the Australian Institute of Health and Welfare.
More than 3 million Australians — an eighth of the country’s population — are getting at least one opioid prescription a year.
In the U.S., drug companies such as OxyContin maker Purdue Pharma are facing more than 2,000 lawsuits accusing them of overstating the benefits of opioids and downplaying their addictiveness.
In Australia, pharmaceutical companies by law cannot directly advertise to consumers, but can market drugs to medical professionals. And they have done so, aggressively and effectively, by sponsoring swanky conferences, running doctors’ training seminars, funding research papers and meeting with physicians to push the drugs for chronic pain.
“If the relevant governing bodies had ensured that the way the product was being marketed to doctors especially was different, I don’t necessarily think we would see what we’re seeing now,” says Bee Mohamed, who until recently was the CEO of ScriptWise, a group devoted to reducing prescription drug deaths in Australia. “We’re trying to undo ten years of what marketing has unfortunately done.”
In poor, rural areas, access to pain specialists can be logistically and financially difficult. Wait lists are long, and a few sessions with a physiotherapist can cost hundreds. Under the government-subsidized prescription plan, a pack of opioids costs about $4.50.
Australia’s government insists it is now taking the problem seriously. Codeine, once available over the counter, was restricted to prescription-only in 2018. And last month, the country’s drug regulator, the Therapeutic Goods Administration, announced tougher opioid regulations, including restricting the use of fentanyl patches to patients with cancer, in palliative care, or under “exceptional circumstances.”