The National Drug and Alcohol Research Centre (NDARC) reported in July 2017 that the rate of accidental opioid deaths has more than doubled among Australians aged 35 to 44 between 2007 and 2013. The estimates for 2014 and 2015 indicate an upward trend.

Alarmingly, the report shows:

  • 70% of the deaths were due to strong prescription painkillers
  • An ageing population experiencing chronic pain is partly to blame for the trend
  • High opioid prescription rates for low back pain may have led to the increase in opioid related deaths
  • Despite opioid known side effects such as addiction, withdrawal pain and tolerance to the drug, opioids continue to be prescribed at high rates
  • The deaths were preventable.

The historical timeline

  • 1990s – The under-treatment of pain was highlighted as a serious medical issue. Doctors, seeking to assist their patients, turned to opioid pain killers reassured by pharmaceutical companies that these drugs were safer than other painkillers on the market
  • 2007 – US Pharmaceutical and 3 of its executives were fined US$634.5 million for its false claims in an OxyContin case
  • 2012 – US doctors wrote 259million prescriptions for opioids
  • 2014 – Over 100,000 deaths in the US were linked to prescription opioid overdose (40% of all overdose deaths reported that year). As doctors pull back on prescribing opioids, addicted patients can switch to other drugs, such as heroin, if not managed properly.

Managing chronic non-cancer pain 

  • Opioid painkillers for non-cancer pain are only appropriate for acute pain used in low dose for a short time. De-prescription should be considered at every visit
  • A multidisciplinary approach to pain management where opioids (in isolation or in combination with other drugs such as benzodiazepines) are prescribed by one clinician with the appropriate Schedule 8 authorities is the gold standard. Consultation and/or referral to a Pain Clinic is recommended
  • Is medicinal cannabis the new medication of choice? The jury is still out. It is not without its side-effects and clinical trials are underway to assess the risks and benefits
  • There is good evidence that psychological and behavioural treatment can successfully help people in managing their chronic pain
  • The Pain Management Network website has excellent resources for healthcare professionals, consumers and patients.

Join the discussion by attending an MIGA Conference and the Mock Coronial Inquest “Who dunnit? A poisonous pill”. You can book your place via the Client Area at  www.miga.com.au.

Other resources

  1. Read the NDARC Report

    Accidental Opioid Deaths in Australia 2013

  2. The Pain Management Network

    Resources for you and your patients

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