New report triggers call for national overdose strategy

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There were 2,070 drug-induced deaths in Australia in 2018, of which 1,556 were unintentional, according to the Penington Institute’s Annual Overdose Report.

It says that from 2001 to 2018, during which time the Australian population increased by 29.9 per cent, the number of unintentional drug-induced deaths increased by 58.6 per cent.

The new report triggered calls for a national overdose strategy with Penington Institute CEO John Ryan saying, "There are no simple solutions. Real-time prescription monitoring has been claimed as a silver bullet and is an easy-to-understand supply-side intervention. But a technological fix is not enough to solve this complex problem.

"Prescription monitoring can lead to people being excluded from the care they need, increasing overdose risk and curtailing access to essential pain care.

He added, "A comprehensive national overdose strategy would be a good start if it had clear indicators to end overdose, as would expanding the Take Home Naloxone Pilot from three states to every jurisdiction in Australia. There is much more to be done – but at a minimum, we need an overdose educated and empowered community."

Opioids, including pharmaceutical opioids, were the biggest contributor to the number of unintentional deaths with 900, followed by benzodiazepines, stimulants, anti-depressants, cannabinoids, anti-psychotics and anti-convulsants.

The report says the number of unintentional drug-induced deaths involving opioids has nearly trebled in the last 12 years, increasing from 338 in 2006 to 900 in 2018.

However, and importantly, the rate of growth in deaths caused by opioids has declined.

Between 2014 and 2018, while opioids were the drug group most commonly identified in unintentional drug-induced deaths, the annual number rose just 9 per cent from 853 to 900.

Deaths involving pharmaceutical opioids have constituted the majority of unintentional deaths due to opioids since 2004. However, the rate of growth has slowed to the extent deaths involving heroin have overtaken those involving pharmaceutical opioids.

Deaths where four or more substances were detected increased by 123 per cent from 261 in 2014 to 582 in 2018.

Over the same period, the number of deaths reported annually from stimulants rose 77 per cent from 250 to 442 and benzodiazepines 34 per cent from 485 to 648.

The TGA and Pharmaceutical Benefits Advisory Committee (PBAC) recently took action designed to curb the number of deaths and hospitalisations caused by prescription opioids.

The TGA has required companies to register new smaller pack sizes for some immediate-release opioid analgesics while the PBAC recommended new restricted benefit listings for smaller maximum quantities of those immediate-release opioids listed on the PBS (codeine, codeine with paracetamol, hydromorphone, morphine, oxycodone, and tramadol) with no increased quantities or repeats.

The Penington Institute’s report found over 40 per cent of the unintentional deaths were in people aged over 50. Males were almost three times as likely as females to suffer an unintentional drug-induced death in 2018, accounting for 71.5 per cent of deaths.