The AHIW Report showing widespread prescription misuse, highlights need for immediate real-time recording, says Guild
The number of Australians misusing pharmaceutical drugs is rising, according to the release of a report Australian Institute of Health and Welfare, Non-medical use of pharmaceuticals: trends, harms and treatment: 2006-07 to 2015-6.
The report looks at two main types of pharmaceuticals: opioid analgesics, including morphine, codeine and tramadol; and benzodiazepines.
“Over the past decade, there has been a substantial rise in the number of deaths involving a prescription drug, with drug-induced deaths more likely to be due to prescription drugs than illegal drugs,” says AIHW spokesperson Matthew James.
In 2016 there were 1,808 drug-induced deaths in Australia, with benzodiazepines the most common single drug type, identified in 663 drug-induced deaths.
This is followed by 550 deaths from other opioids (including prescription painkillers such as oxycodone, morphine, and codeine).
The report shows that in 2016 about a million Australians (4.8% of the total population) aged 14 years or older had misused a pharmaceutical drug in the past 12 months. This was up from 3.7% in 2007.
In 2016, the non-medical use of pharmaceuticals was higher than all illegal drugs, except cannabis (10.4%).
The general trend is consistent with international observations: the AIHW singles out non-medical use of pharmaceuticals and resulting harms especially in the US and Canada, where these are also rising.
The rate of dispensed prescriptions for opioids has risen by 24% —from 36,900 per 100,000 population in 2010–11 to 45,600 per 100,000 population in 2014–15, while prescriptions for benzodiazepines have remained fairly stable.
Guild president, George Tambassis, said the Report “disturbingly” showed a 24% spike in prescriptions for opioids between 2010-11 and 2014-15. This rise was underpinned by a 60% increase in prescriptions for oxycodone.
“These figures and the findings of the report are a wake-up call that governments and health professionals need to work together to implement real-time monitoring as a matter of urgency,” Mr Tambassis aid.
“Demonstrably there is a need for mandatory national real-time recording of medicines which are subject to abuse and dependence or cause harm.
“Such a real time recording system must operate across pharmacies and doctors’ surgeries to be effective.
“Greater vigilance and better exchanges of information among health professionals is also clearly needed.”
Mr Tambassis said that while the report’s findings were alarming, they pre-dated the introduction of MedsASSIST – a real-time recording system for medicines containing codeine which was voluntarily developed by the Guild and rolled out to pharmacies in March 2016.
“In the 20 months since MedsASSIST was introduced, it has been taken up voluntarily by more than 70% of community pharmacies, with over 10 million purchases recorded,” he said.
“There has been an overall reduction in supply of about 15%, with some pharmacies that use MedsASSIST experiencing reductions in supply of over-the-counter codeine products in the vicinity of 40%.
“The pity is that this voluntary real-time recording system will become redundant from 1 February next year when all products containing codeine are made prescription-only. There is currently no national system in place to monitor prescriptions written by doctors.
“The Guild has called for this real-time recording to be made mandatory across all States and Territories. The AIHW report reinforces this call.”
Mr Tambassis said the Guild was also concerned over the lack of post-hospitalisation reconciliation of medicine use as that is where many addictions arose.
“Simply giving patients a big bag of medicines when they leave hospital is just not appropriate and the transition from hospital to home or care is where much of medication misuse can arise,” he said.
“Building community pharmacies into this transition is essential. Pharmacists are the medicines experts and community pharmacies are easily accessible to help patients manage their medicines when they leave hospital rather than leaving them to self-manage.
“A structured transition plan with community pharmacists at its core can help prevent a problem from occurring rather than leaving it till the patient becomes a statistic in reports like this latest one from AIHW.”
NSW Pharmacy Guild president David Heffernan pointed out that misuse does not mean abuse. “For example, it may mean a person accidentally took two instead of one Panadeine.
“The prescription death rate is concerning. The data suggests that some patients with a prescription addiction may have previously sought access to OTC medication before MedsASSIST.”
“The real time recording must operate across pharmacies and doctors’ surgeries to be effective. As from February 1 there will be no real time monitoring system in place and there is no system in place to monitor prescription opioids.
“While the report mentions the announcement of a federal real time monitoring program, it is still just that—an announcement.”
