NEW-AGE HEROIN: The prescription drug crisis killing Australians

[poledriver]

'HELL OF A PROBLEM': Prescription drugs fuel alarming death spike

DRUGS prescribed by doctors and peddled by pensioners fuel the worst spike in opiate overdoses since the 90s. The epidemic is killing “mainly young people” with “uncomplicated backgrounds”.

IT'S our new drug crisis.

Australia is experiencing its biggest spike in opiate-related deaths since the heroin epidemic of the 1990s, but the majority of deaths are being blamed on prescription painkillers such as oxycodone - also known as 'hillbilly heroin' – and morphine.

An analysis by researchers at the National Drug and Alcohol Research Centre (NDARC) at the University of New South Wales, found 500 Australians aged 15 to 54 died of an opiate overdose in 2008, up from 360 in 2007.

The report, based on the latest figures from the Bureau of Statistics, projects this figure will climb to 705 overdose deaths in 2010 when figures for that year have been confirmed.

Dr Alex Wodak, a drug and alcohol expert at St Vincent's Hospital in Sydney, said the deaths were tragic and avoidable.

“It’s the equivalent of two jumbo jets crashing in the air,” he said. “That’s the families of 705 people distraught with grief.

“We’ve got a hell of a problem.”

The NDARC report confirms that only 30 per cent of the deaths in 2008 were related to heroin. The other 70 percent were from other opiates, such as morphine and oxycodone.

Oxycodone, which is prescribed by doctors for severe pain, was implicated in the death of actor Heath Ledger in 2008.

Dr Wodak said the hospital had seen increasing numbers of “mainly young people” with “uncomplicated backgrounds” who had problems with prescription opiate drugs, like the brand OxyContin.

While some were using drugs such as Oxycodone for recreational use, others had been prescribed the drugs to deal with chronic or severe pain and had become addicted.

“These people have had reasonable education, a stable partner, lived in the same place for years, a good job, and this was the only problem they really had in their lives,” he said.

Dr Marianne Jauncey, medical director of the Medically Supervised Injection Room in Sydney’s Kings Cross, said the majority of patients using the centre are now using prescription opiates rather than heroin.

Dr Jauncey said the centre started seeing rising rates of patients injecting prescription opiates in 2005 and their number has increased steadily since, especially in the last three years.

“We reached the stage a few years ago when we started to see more prescription opioids in our centre than heroin,” she said.

“The most common drug is now prescription opiates – that’s a combination of oxycodone and morphine.”

There has never been a death from a drug overdose at the centre but in unsupervised conditions it's a different story.

While some of the spike may be attributed to statistical changes over the years, the lead researcher on the project, Amanda Roxburgh, says prescription opiates are likely fuelling the worrying trend.

The high number of opiate related deaths is in stark contrast to 82 accidental deaths from methamphetamines and 16 from cocaine in 2008.

Males made up 74 per cent of the opiate deaths in 2008, the NDARC report said. Australians aged 25 to 34 were the biggest victims of opiate use (39 per cent), followed by 35 to 44 year olds (32 per cent).

Prescription opiate deaths mostly occur after being combined with other drugs, like alcohol and sleeping tablets.

The current rate of opiate-related deaths is the highest since 2000. In 2001, the death rate plunged from 938 to 387 mostly due to a shortage in heroin availability.

At the height of the heroin epidemic in the late 1990s more than 1000 Australians were dying a year.

Killer drugs peddled by pensioners

The rate of doctors prescribing the opiate oxycodone soared by 152 per cent between 2002 and 2008, according to recent study in the Medical Journal of Australia. Prescriptions were particularly high for over 60s.

The increase came after the Federal Government removed restrictions on the availability of pharmaceutical opiates more than a decade ago.

Previously the drugs were mostly prescribed to cancer patients or people with serious medical conditions, but leading drug and alcohol specialists say the softening of restrictions has led to the drugs being “overprescribed”.

James Pitts, CEO of drug rehabilitation service Odyssey House says doctor shopping - where patients go from doctor to doctor with their symptoms and sell surplus oxycodone to dealers - has also become a serious issue.

“There’s a big financial incentive in this,” Mr Pitts said. “You can get a prescription of 20 to 30 tablets for about $50 or $70 a piece.”

Medical authorities told the ABC in 2009 that elderly people were selling OxyContin for $100 on the black market.

Professor Richard Mattick from the National Drug and Alcohol Research Centre said opiate therapy for treatment of chronic pain was now widespread but was “questionable” largely due to the addictive properties of the drugs.

He added that doctors were often under pressure from patients to prescribe the drugs.

“You have a more liberal availability [of oxycodone]. The downside is people will die,” he said.

The Federal Government is working to expand a program running in Tasmania which tracks prescriptions of opiates in a bid to cut down on the problem of doctor shopping.

A spokesperson for the Department of Health said that the initiative, the Electronic Recording and Reporting of Controlled Drugs, had the support of every state and territory.

http://www.news.com.au/national/dan-drugs/story-fndo4eg9-1226500952645

 

[poledriver]

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

The Punch spoke to Tony last week to hear his tragic story. His son Damien – a school prefect, an accomplished athlete – died at just 23.

A heroin epidemic was at its worst in the late 1990s. 713 Australians, the amount of humans you’d find in an average-sized school, overdosed on opiates in 1997.

Damien Trimingham was one of them, dead on a hospital stairwell after injecting himself with heroin.

In the past decade, the flood of heroin hitting our streets has receded. The epidemic ended in 2001.

You might be reading this and thinking: “yeah, heroin, it’s a ‘90s drug”. It does kill fewer Australians now.

But Trimingham Senior, who founded an organisation called Family Drug Support after his son’s death, sounded astonished when The Punch brought him up to date with the latest death rates from opiates.

They’ve spiked. 705 Australians overdosed on the drugs accidentally in 2010, a report from the National Drug and Alcohol Research Centre projects.

Nearly as many as the death toll when Damien Trimingham died in ‘97.

That’s up from 500 confirmed deaths in 2008, and 360 the year before that.

The twist is it’s not so much from heroin. Only 3 in 10 deaths were from the stuff. Instead, the spike was likely fuelled by an increase in overdoses on prescription painkillers.

7 in 10 deaths were from drugs like oxycodone and morphine, both legally prescribed by doctors.

Experts told The Punch the stuff is being overprescribed.

Once upon a time oxycodone was used mostly for pain related to cancer, but that’s changed.

It’s prescription rates have soared 152 per cent between 2002 and 2008 after the Federal Government lifted restrictions on it more than a decade ago.

The Punch understands there’s a thriving black market for oxycodone and similar drugs.

It’s being peddled by nans and pops, often with real pain-related medical conditions, who can make a nice profit by getting prescriptions from doctor after doctor and passing it onto a drug dealer.

Yep: Have YOU checked what your gramps have been up to lately?

But in all seriousness, there’s two ways the drug epidemic can be slowed, according to Dr Alex Wodak, who was the head of Drug and Alcohol Services at St Vincents hospital in Sydney for 20 years until this June.

First: there should be a tracking system in place to stop “doctor shopping”. The Federal Government’s working on that.

And there’s another. There are few things we don’t ever really want in our backyards. Nuclear power plants: check. Paedophiles: check x a billion. Methadone clinics: yeah, probably, check.

Dr Wodak says we need more of them because they’d reduce the price of the drugs on the black market.

There’d be less demand because there’d be less of a market. And more of the drug-addled on programs that’d help them.

Yeah, if you live in Sydney, it’s a heroin injecting centre debate on a big scale. The same centre which says it’s seeing more prescription opiate patients than heroin patients nowadays.

And sure, it’s hard to feel sorry for people who are on the verge of becoming junkies.

But what’s better: Hundreds dying, hundreds of families in grief?

Or occasional neighbourhood unpleasantness, hopefully out of the way from everyone else. And what’s more unpleasant: a heroin addict, or someone who’s making the effort to get off the stuff.

It’s not pretty. But it’s something we might just have to cop. Because there was a remembrance ceremony for Tony’s son and others who’d died of drugs earlier this week, and well, there are so many like him to remember.

With comments -

http://www.thepunch.com.au/articles/you-dont-expect-to-die-when-you-take-a-painkiller/

 

[poledriver]

How to reduce opioid overdose deaths in Australia

Once again, overdose deaths from opioids are increasing in Australia. And once again, we are in danger of ignoring effective, evidence-based interventions.

According to the National Drug and Alcohol Research Centre, there were 360 opioid overdose deaths in 2007 but 500 in 2008 – a 40% increase. These overdose figures have been carefully checked.

Preliminary figures suggest that there were 612 such deaths in 2009, a 22% increase from 2008, and 705 in 2010, a 15% increase from the year before. Increases in overdose deaths occurred in all of the major states but were most marked in Victoria where such deaths increased 133% from 73 in 2001, to 170 in 2008.

Most of these deaths are due to heroin but an increasing number have recently been due to pain relieving prescription opioid drugs. Most involve men in their early 30s.

And for every fatal overdose, there are many more non-fatal overdoses. Non-fatal overdoses can result in severe physical and mental damage, expensive ambulance call outs and admissions to hospital emergency departments and intensive care units. So the health and financial costs of non-fatal overdoses to individual young Australians and the community are anything but trivial.

Recent trends

Heroin is produced from opium and most of the heroin reaching Australia originates from Burma. The last time opium production peaked in Burma was in the mid-1990s. That increase resulted in a glut of heroin in Australia and annual opioid overdose deaths peaked at 1,116 in 1999.

Opium production in Burma decreased 82% from 1,760 metric tonnes in 1996 to 312 metric tonnes in 2005. Annual opioid overdose deaths in Australia fell to 938 in 2000 and then to 386 in 2001. Opioid overdose deaths then remained below 400 until 2008.

In recent years, Burma’s opium production has increased 88% from 312 metric tonnes in 2005 to 586 metric tonnes in 2010. If this trend continues, Australia could once again experience the extremely high levels of overdose deaths that occurred in the 1990s.

The shortage of heroin in Australia that began in 2000 (and also affected some other countries) coincided with the sharp decline in opium production in Burma between 1996 and 2005. This decline was probably due to a combination of factors including the retirement of a major Burmese opium warlord (Khun Sa), a shift from outdoor opium cultivation (easily detected by aerial and satellite surveillance) to indoor amphetamine production, increasing consumption of heroin in China en route to Australia and local climatic changes.

Inevitably, some Australian politicians claimed at the time the shortage was due to the then new “tough on drugs” policy; they were less enthusiastic about accepting responsibility for the increase in amphetamine use that followed the heroin shortage.

Treatment options

There are several things we can do to address this looming problem. First, we could expand and improve our drug treatment system and reduce the barriers to entering and remaining in treatment. There’s copious high-quality evidence that methadone and buprenorphine treatments are effective and safe. For every $1 spent on these treatments, there’s a community saving of $4 to $7.

Methadone and buprenorphine reduce the excess risk of death among people who inject heroin by about 80%. And a recent study suggests that these treatments reduce the risk of HIV by over 50%. They also reduce property crime substantially.

But most people who enrol in methadone or buprenorphine programs have to pay at least $50 per week from what is usually a very low income. And there’s far more demand than supply of such treatments in most parts of Australia.

What’s more, the treatments are very stigmatised, especially methadone. Many patients enrolled in methadone and buprenorphine treatment complain that staff don’t treat them with respect. Many don’t even bother trying to enter treatment and others leave far too early.

Stigma is one of the nasty side effects of our punitive approach to illicit drugs. The experimental and unapproved drug naltrexone is also advocated by some as something of a panacea but a recent NHMRC review concluded that there was insufficient evidence that this drug is effective or safe.

Safer injecting

Safe injecting facilities (like the Kings Cross Medically Supervised Injecting Facility) also reduce the risk of fatal and non-fatal opioid overdoses. They mainly cater for the most disadvantaged subset of an already very disadvantaged population of people who inject drugs.

Many of the people who attend the 90 safe injecting facilities around the world have severe physical and mental illnesses, are homeless and very isolated. Many have had little or no previous contact with health or social agencies, including those providing drug treatment.

Safe injecting facilities are only needed near or within large drug markets (where most overdose death occurs) that spill over into surrounding neighbourhoods. Australia only needs a few such facilities in half a dozen major cities in the country.

New South Wales accounts for almost half of Australia’s drug overdose deaths and a fifth of these deaths occur within two kilometres of Kings Cross. Safe injecting facilities also improve neighbourhood amenity so they’re usually very popular with local residents.

Trying to repair the severe and multiple problems that have developed over the many years of injecting drugs takes a lot of time and a lot of effort. People who use drugs, their families and communities often look for a magical quick-fix solution that will instantaneously sort everything out perfectly. So too do our politicians.

Unfortunately, there are no quick fixes. But there are effective and pragmatic interventions that will save hundreds of lives and millions of dollars. What we need to do is ask ourselves if we are ready to think about these interventions for people who are someone’s son or daughter, sister or brother, father or mother.

http://theconversation.edu.au/how-to-reduce-opioid-overdose-deaths-in-australia-10197

 

[PriestTheyCalledHim]

Are Oxy and hydro new in Australia or something?

 

[Crankinit]

No, but they were much more underground and less widespread for quite a while.

The article is quite right that the methadone/bupe program needs substantial reworking and expansion. When I first looked into getting onto maintenance, the methadone clinics were all full and had so many people in line that they wouldn't even accept new names on the waiting list, and that's in a city with a much, much smaller opiate scene than Sydney or Melbourne. Not only that, but both the cost and time requirements are very prohibitive.

 

[paranoid android]

^ Yeah it's the same in my part of Canada the methadone program is a total clusterfuck. You have people waiting 3 months to get on methadone (bupe is not even covered here under government insurance) because there are only a few doctors that have a license to prescribe it. That combined with the fact that you may have to drive a hour or more depending on just where you live to get to the nearest pharmacy that is willing to dispense methadone makes the system almost unworkable.

 

[Hiltoniano]

Hillbilly fucking heroin. Oxy and heroin are NOT the same. Why do newspeople always do that shit, comparing something kinda bad to the worst thing in the public eye? Oh wait.....

 

[Crankinit]

In terms of their actual effects the difference is exceedingly minor, to be fair.

 

[Portillo]

There is so much garbage in those articles. What the hell is this supposed to mean, "The epidemic is killing “mainly young people” with “uncomplicated backgrounds”.

 

[teological]

Bloody hell, I just saw this now on TV, and had a peak at the Blue Light Media forum. I am sick of opiates and drugs being in the media. In Australia, the spotlight was on Fentanyl because of ambulance officers stealing it. On the radio they call is a high power opiate (which it is), but it just gives the term opiate a bad name. That was what, two weeks ago?

Now we have this bullshit out of no where. Oxycodone blah blah fucking blah, opiate wooo cry cry, fuck off you bastards. Look at regulatin GOD DAMN CIGARETTES you bastards. How does that do for ya with deaths ay? Or your fucking alcohol you dogs, and the violence/OD that causes every fucking weekend you fuckwit fucking bastards.

 

[poledriver]

My prescription hell: Addicted to deadly drugs


MEREDITH Elliott was 23 when she broke her neck in a car accident in Bangkok. For the last 15 years the Wollongong mum-of-two has been in constant pain and unable to work.

But in spite of what she’s been through, one of her most traumatic experiences has been with the painkiller OxyContin.

“You wouldn’t get me near oxy again,” said Elliott, who was prescribed the drug for nearly four years. “It’s like living in your own glad-wrapped world.”

“There are people out there who enjoy how it makes them feel but… they’re mad.”

News.com.au revealed earlier this week that prescription opiate painkillers like Oxycontin are driving an alarming spike in opiate overdoses in Australia, rather than heroin.

Figures from the National Drug and Alcohol Research Centre show the biggest spike in opiate overdose deaths since the heroin epidemic of the 1990s. 705 people are projected to have died from opiate overdoses in 2010, up from 360 in 2007.

After four years on the drug, Elliott spent an excruciating three months weaning herself off, a process that involved severe, heroin-like withdrawals.

She spent weeks on the couch, sweating profusely, shaking, vomiting and hallucinating.

“The doctor told me: If you stop it cold turkey you’ll die. That scared the crap out of me.”

The biggest spike in opiate deaths since the heroin epidemic in the 1990s is being blamed on prescription painkillers like oxycodone.

Experts like James Pitts, CEO of the rehabilitation centre Odyssey House, have argued the medication is being overprescribed to patients.

The Federal Government lifted restrictions on the medications more than a decade ago, and prescriptions soared 152 per cent between 2002 and 2008, according to a Medical Journal of Australia study.

Oxycodone users who contacted News.com.au were split about whether it needed more regulation.

One reader wrote: “I am constantly in serious pain every single day and night.

“Currently it is very difficult to get access to pain medication of any kind due to current regulations."

But readers were unanimous that there is no good pain-relieving alternative to the medication.

“Although long-term use is not good for your body, there is no alternative,” said the same reader.

Meredith Elliott, who uses the drug Lyrica to tamp down some of the nerve pain, put forward a controversial suggestion.

“I understand there’s been research in Israel where they’ve planted a marijuana plant that they’ve taken all the high-inducing stuff out of.

“I’d prefer to take it. But the Government’s like: uh, marijuana’s bad.

“If the Americans can not be so uptight about it, why can’t we?”

Several American states are set to vote on legalising medical marijuana at the US election next month.

With comments -

http://www.news.com.au/national/my-...-to-deadly-drugs/story-fndo4eg9-1226503894027

 

[23536]

No, but they were much more underground and less widespread for quite a while.

The article is quite right that the methadone/bupe program needs substantial reworking and expansion. When I first looked into getting onto maintenance, the methadone clinics were all full and had so many people in line that they wouldn't even accept new names on the waiting list, and that's in a city with a much, much smaller opiate scene than Sydney or Melbourne. Not only that, but both the cost and time requirements are very prohibitive.

You guys (Australia) could open private clinics that take cash instead of government insurance. If there is such a demand, they'd surely be profitable.

D.A.R.E. to keep kids off socialism.

 

[AminoAcid]

The article is quite right that the methadone/bupe program needs substantial reworking and expansion.

This is definitely true. I've been through the quagmire of both Sydney and Melbourne bupe programs, and the Melbourne system is so much more functional and superior in every way:

- Less expensive.
- You can go to your local pharmacy to get it instead of traveling ages to a distant designated crap-hole to wait around with shady freaks.
- To see the doctor for an appointment only takes about 10-15 minutes in Melbourne, but around 3-4 hours in Sydney (and that's NOT an exaggeration).
- Take-away doses much easier to acquire from the doctor in Melbourne.
- Much harder to find a provider in Sydney, every public clinic was full, and only scarcely managed to get into a private one.
- This may be different with individual clinics, but found the people in Melbourne to be much much nicer to the clients, pretty much the same as just going to your local doctor for a check-up.

Luckily I was a student when on this stuff living off parental $, as there's NO WAY I could've been on the Sydney program and had a functional professional life, it just takes up too much time. It almost feels like you're being punished it's that inefficient.

So this could be one of the reasons why the death-toll in Sydney is so high. $70 a week (plus travel costs) adds up very fast and for many would probably be out of the question.

 

[Crankinit]

The amount of fuss the media are making about this so called 'epidemic' is absurd. This has been going on for years, but suddenly they're jumping all over it? Must be a slow news week.

This is definitely true. I've been through the quagmire of both Sydney and Melbourne bupe programs, and the Melbourne system is so much more functional and superior in every way:

- Less expensive.
- You can go to your local pharmacy to get it instead of traveling ages to a distant designated crap-hole to wait around with shady freaks.
- To see the doctor for an appointment only takes about 10-15 minutes in Melbourne, but around 3-4 hours in Sydney (and that's NOT an exaggeration).
- Take-away doses much easier to acquire from the doctor in Melbourne.
- Much harder to find a provider in Sydney, every public clinic was full, and only scarcely managed to get into a private one.
- This may be different with individual clinics, but found the people in Melbourne to be much much nicer to the clients, pretty much the same as just going to your local doctor for a check-up.

Luckily I was a student when on this stuff living off parental $, as there's NO WAY I could've been on the Sydney program and had a functional professional life, it just takes up too much time. It almost feels like you're being punished it's that inefficient.

So this could be one of the reasons why the death-toll in Sydney is so high. $70 a week (plus travel costs) adds up very fast and for many would probably be out of the question.

Jesus, I thought I was getting ripped off abominably paying that much a fortnight, $70 a week is straight up extortion of desperate addicts. When you consider that a box of oc80's can be bought at the pharmacy for $5 - $20, there's really no valid justification for such a price.

I'm just grateful I was able to find a doctor to write me a private script for bupe so I don't have to deal with the humiliating, punitive clinic system.