Ms Amanda Roxburgh, senior researcher at the National Drug and Alcohol Research Centre, and co-authors conducted a study analysing trends in prescriptions for morphine and oxycodone, hospital separations for overdose, treatment episodes related to morphine or oxycodone, and the number of oxycodone-related deaths.
They found that between 2002-03 and 2007-08, morphine prescriptions decreased by about 20 per cent compared with a 152 per cent increase in prescriptions for oxycodone. Prescriptions for both were highest among older Australians.
Ms Roxburgh said the study showed that treatment episodes for morphine remained stable, while those for oxycodone increased, and that 90 per cent of the 465 oxycodone-related deaths recorded during 2001-09 involved either the use of the drug in combination with other opioids, benzodiazepines and alcohol, or the contribution of concomitant medical conditions.
“There is a continued need for comprehensive training of general practitioners in assessing patients with chronic non-malignant pain and prescribing of opioids for these patients, to minimise the potential harms associated with use of these medications,” Ms Roxburgh said.
In an accompanying editorial in the MJA, Prof Wayne Hall, from the Centre for Clinical Research at the University of Queensland, writes that simple strategies are available to policymakers and doctors that can reduce harms from misuse of pharmaceutical opioids.
“Whatever policies are implemented, it is essential that we assess rigorously their impacts on both the quality use of these medicines in relieving chronic pain and on the harms arising from their inappropriate use,” Prof Hall said.
In a Letter to the Editor, Dr Mark Awerbuch, a rheumatologist in Adelaide, advocates that a signed patient-doctor agreement should be mandatory in Australia before the prescription and dispensing of opioids for chronic non-cancer pain.
“A review of prescription guidelines for opioid analgesics in chronic non-cancer pain might reduce the epidemic of prescription drug misuse and mortality,” Dr Awerbuch said.
