A Prescription for Disaster

PRESCRIPTION DISASTER In the last ten years, Australia has seen an explosion in the number of people addicted to prescription medications such as painkillers and anti-anxiety drugs. The result has been a huge number of hospitalisations and deaths. Those vulnerable are often well-educated, otherwise high-functioning individuals and certainly a far cry from a 'typical' drug addict. Many of these people are first exposed to addictive medication after an accident or anxiety attack, and hence become 'accidental addicts.' Without the tools to check a patient's prescription history, doctors are left to guess at patients' veracity. IN VICTORIA, ACUTE DRUG TOXICITY DEATHS INVOLVING THESE PRESCRIPTIONS HAVE IN VICTORIA ALONE, MORE PEOPLE DIED PRESCRIPTION MEDICATIONS FROM PRESCRIPTION SOUND SAFE? DRUG OVERDOSES IN 2012 THINK AGAIN... THAN WERE KILLED IN VEHICLE ACCIDENTS THAT YEAR CLIMBED STEADILY DEATHS 120 300 280 100 240> 200 80 160 120 DIAZEPAM (VALIUM) 80 60 40 00000 METHADONE 2010 2011 2012 4 OUT OF 5 VICTORIAN OVERDOSE DEATHS OXYCODONE - 20 ARE RELATED TO PRESCRIPTION DRUGS I ALCOHOL 2009 2010 2011 2012 I ILLICIT DRUGS I VEHICLE I PRESCRIPTION MED OVERDOSE I tell doctors that if you're going to do this, you have to tell someone: 42-YEAR-OLD MAN SAID HE WAS MORE LIKELY TO BE SOLD CODEINE IF HE WAS DRESSED IN A SUIT AND TIE, ACCORDING "I can fix your anxiety today by making you an addict for the rest of your life. Is that what you want?" TO A 2013 STUDY QUOTED IN THE AGE NEWSPAPER IN VICTORIA -Dr. Nick Carr, Melbourne physician WHAT IS 'DOCTOR SHOPPING'? "Doctor shopping" or "prescription shopping" is the practice of a patient visiting multiple prescribers to obtain more medication than they require. The drugs they seek may be for personal use or to sell on the illicit drug market. $7* million OPIOID PRESCRIPTIONS UNDER THE PHARMACEUTICAL BENEFITS SCHEME (OXYCODONE, HYDROCODONE, ENDONE, MORPHINE, FENTANYL, ETC.) $2 million 5827 FROM 2010 TO 2012, AMBULANCE CALLS IN METRO MELBOURNE WERE Benzodiazepines (Valium, Xanax) FAR MORE FREQUENT FOR EVENTS INVOLVING ANTI-ANXIETY MEDS 1992 - - 2007 THAN FOR HEROIN 3943 IN TWO DECADES, Heroin THE PHARMACEUTICAL OPIOID SUPPLY OUTSTRIPPED THE POPULATION ALMOST 8-FOLD 15 YEARS AGO, PHARMACEUTICAL PHARMACEUTICAL OPIOIDS OPIOIDS ACCOUNTED FOR ONLY 33% OF OPIOID POISONINGS. POISONING BY 2007, THE SHARE 228% HAD CLIMBED TO 80% 2000 2400 29% 1991 AUSTRALIA'S POPULATION 2010 2007 1998 DIRECTLINE, A TELEPHONE COUNSELLING SERVICE, NOW RECEIVES ALMOST WHY CAN'T WE MONITOR PRESCRIPTION THREE TIMES AS MANY CALLS MEDICATION ABUSE BETTER ALREADY? ABOUT PRESCRIPTION OPIOIDS Existing monitoring systems can't identify and track medications to the individual patient level AS IT DOES ABOUT HEROIN 31%- Many systems do not cover all prescription drugs, and take months to report Opioid calls 12% Regulation of pharmaceutical opioids varies between jurisdictions Heroin calls Information is held by different agencies and is not merged to form a comprehensive picture Police do not have access to the data they require to effectively respond to illicit sales of medications NEW YORK STATE REPORTS In its first three days, the real-time prescription monitoring system discovered and stopped at least 200 instances of apparent doctor shopping O 200 RECOMMENDED SOLUTIONS 74% Doctor shopping dropped 74% from the fourth quarter of 2012 to the fourth quarter of 2013 Rapid deployment of a real-time prescription monitoring system, much like those used in New York and other U.S. states. In six months, more than 7 million prescriptions were checked by NY health providers Status: While the Australian federal government has approved and funded an electronic prescription registry, state and territorial governments have been slow to implement it. million Stricter rules governing the prescribing of opioid and benzodiazepines. THIS ISSUE MUST BE ADDRESSED VISIT DrShopping.org or email [email protected] JOIN THE NATIONAL MOVEMENT CALLING FOR CHANGE in Tansor torian Coroner's Preventio ADDICT ARE DIFFICULT TODETEG OPIOID SUPPLY 400 Source: Turning Point Alcohol and Drug Centre 800 1200 1600