Opioids prescribed for the right patient can be an important part of good healthcare.
Opioids do however offer significant potential for inappropriate use, morbidity and mortality when not used in the right way.
The opioid challenge
According to the latest Penington Institute figures, there were 904 unintentional overdose deaths involving opioids in Australia in 2017, and opioids are the most common element in unintentional overdose death, trebling in the last 10 years.¹ The Australian Institute of Health and Welfare estimates opioid use was responsible for 1% of the total burden of disease and injuries in Australia in 2015.²
Clearly opioids are a significant challenge for Australian governments, healthcare providers and the community.
MIGA is involved in a range of projects around ensuring appropriate opioid use, particularly through our advocacy and education.
There are recently announced changes to providing information about and supply of opioids.
New opioid information and distribution changes
The Therapeutic Goods Administration (TGA) has now announced changes to how a range of opioids are distributed in Australia, including
- Smaller pack sizes will be available for immediate-release prescription opioid products – this is of particular relevance in a range of post-operative settings
- Boxed warnings and class statements in the Product Information documents describing their potential for harmful and hazardous use – indications will reinforce that opioids should only be used when other analgesics have proven not to be effective
- Work with opioid sponsors to ensure that safety information is prominently displayed in the Consumer Medicines Information
- Updating indications for fentanyl patches to indicate they should only be prescribed to treat pain in cancer, palliative care and exceptional circumstances.³
These changes follow consultation which MIGA was involved in, and MIGA has been working with the TGA to understand and explain what these changes mean. Importantly they are sensible and practical initiatives that MIGA supported in consultation, preferable to greater restrictions on prescribing and access, which may unintentionally limit appropriate opioid use.
Opioids – the work continues…
More broadly, MIGA’s ongoing advocacy efforts include
- Involvement in discussions on various real-time prescribing proposals and implementation
- Engagement with the Commonwealth Department of Health on various Medicare initiatives and proposals, such as ‘behavioural economics’ letters and data matching, which can impact on opioid prescription and use
- Advocating for continued support of the National Prescribing Service MedicineWise initiatives, including Choosing Wisely.
MIGA has recently developed online education modules on both opioid prescribing and medication prescribing more generally. MIGA members can access this through MIGA’s online Risk Management Education – https//reo.miga.com.au, or by emailing firstname.lastname@example.org