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Hot topic: prescription opioids

Prescription opioids

NDARC’s finding that prescription opioids were responsible for more than double the number of accidental overdose deaths than heroin in 2008 hit the headlines with a bang this week.

Everyone from Richard Glover on ABC 702 in Sydney to Paul Murray on 6PR 882 in Perth wanted to know: What is oxycodone? Why are people overdosing on it? And what on earth we can do about it?

Oxycodone is a powerful painkiller that can be used to treat severe or chronic pain.

Amanda Roxburgh, senior research officer at NDARC and author of the report that revealed the overdose trends, explained some of the accidental overdoses were likely to be due to multiple drug toxicity. That is, people mixing their prescription medications or not using the drugs as prescribed.

Roxburgh added there is likely to be a proportion of injecting drug users that turn to oxycodone, morphine or similar substances when heroin is unavailable. Unlike heroin, prescription opioids are consistent in their content and quality. She also clarified that while 30 per cent of opioid deaths were attributable to heroin, the remaining 70 per cent were attributable to a wide range of opioids in addition to oxycodone – including morphine, fentanyl and those used in substitution therapy.

Professor Louisa Degenhardt, who is leading a number of studies on prescription opioid use and diversion, noted that those suffering chronic pain may also be struggling with poor mental health including anxiety or depression. This may contribute to misuse of prescription pain relievers, although we have no data to know for sure.

Dr Marianne Jauncey, who is head of the Medically Supervised Injecting Centre (MSIC) in Kings Cross, noted that in the past five years there had been a steady increase in the number of clients using the centre to inject oxycodone and numbers had now surpassed those injecting heroin.

Unfortunately, there is minimal research on how to prescribe opioids for chronic pain and ensure only those who need them are getting the prescriptions.

This is one of the reasons Professor Degenhardt and her colleagues are currently completing the POINT study, following people who use prescription opioids to gain knowledge on the outcomes of such drug use.

While the publication of the 2008 overdose data has led some to call for greater restrictions on the prescription of opioids, Professor Degenhardt said it was important to remember the physical and mental suffering endured by those who have chronic pain, the likes of whom she’s met through the POINT study.

 “It is so upsetting to hear the challenges these people are facing on a daily basis,” Degenhardt said.

To read some of the media coverage that accompanied our report on opioid overdose, check out the links below:

'Hell of a problem': Prescription drugs fuel alarming death spike

You don't expect to die when you take a painkiller

Fixing the prescription opioid problem is simple, but not easy…

Mornings with Paul Murray

Opiate deaths on the rise: report