One Too Many

One Too Many Victorians are dying due to preventable prescription medication overdose.

ScriptWise’s new One Too Many initiative is dedicated to:

+ Raising awareness about the risks associated with long-term use of prescription opioids such as opioids or benzodiazepines

+ Ensuring Victorians understand the role and importance of SafeScript in saving lives across the State

+ Promoting preventative strategies and activities within communities

One Too Many is being launched in support of the Victorian government’s implementation of its real-time prescription monitoring system, SafeScript, in October 2018.

For 24/7 free and confidential advice, support and referral for people concerned about their use of medicines please contact the SafeScript Pharmaceutical Helpline on 1800 737 233.

Start the Conversation

What is SafeScript?

The Victorian government’s real-time prescription monitoring system, SafeScript, will be implemented in late 2018.

SafeScript is computer software doctors, nurse practitioners and pharmacists will access to see their patient’s prescription history of certain high-risk medicines, such as opioids and benzodiazepines.

Why do we need SafeScript?

SafeScript is being rolled-out because it will:

+ Help health professionals identify and start a conversation with patients who are at risk due to use of highly addictive medications such as opioids and benzodiazepines

+ Ensure Victorians receive effective and up-to-date treatment for prescription medication dependence or underlying conditions such as chronic pain or anxiety

+ Reduce the number of hospital and emergency department presentations. SafeScript is estimated to reduce hospital admissions by over 5,000 and ED presentations by over 16,000.

+ Save lives. In Victoria, more people die due to prescription medication overdose than on our roads. It is estimated that SafeScript will save approximately 500 lives in just 10 years

The Western Victoria Primary Health Network (PHN) catchment will be the study area for the roll-out of SafeScript with education for both the public and health professionals happening from July-September.

Need more information?

+ Visit the Department of Health’s SafeScript website

+ Download the Department of Health’s SafeScript FAQ here

Getting effective treatment

At the moment, One Too Many Victorians don’t know that prescription opioids (such as oxycodone, fentanyl and codeine) and benzodiazepines (sedative medications such as diazepam and temazepam) can be highly addictive. These medications should only be used in the short-term to manage health conditions.

Evidence has shown that the risks associated with long-term use of prescription medications such as opioids or benzodiazepines far outweigh the benefits. But there are effective alternative long-term treatments for medical issues such as chronic pain, anxiety and prescription medication dependence.

Managing pain

One of the most common reasons people are prescribed opioids is to for pain. While opioids are very effective in treating severe pain for a short period of time, there is little evidence that they are helpful long-term. In fact, recent research suggests that long-term use can be harmful: it can cause medication dependence and even make pain worse.

There is also very little evidence that benzodiazepines have any value in the treatment of pain.

The good news is that there are effective ways to manage pain that lasts longer than three months (commonly called chronic or persistent pain).

It’s important to speak with your GP, pharmacist or allied health professional about the most effective pain management available.

Below are some other resources which may be useful for you to find out more about managing your pain long-term.

+ Pain Australia: http://www.painaustralia.org.au/

+ Chronic Pain Australia: http://www.chronicpainaustralia.org.au/

+ painHEALTH: https://painhealth.csse.uwa.edu.au/

+ Australian Pain Management Association: https://www.painmanagement.org.au/

+ Ask Your Pharmacist: http://askyourpharmacist.com.au/

+ Pain Management Network: http://www.aci.health.nsw.gov.au/chronic-pain

+ Pain Link Helpline 1300 340 357

Managing anxiety and sleep problems

Sometimes tranquillisers (‘benzodiazepines’) are prescribed for when you’re having problems with anxiety, stress and sleeping well.

Benzodiazepines such as diazepam and temazepam are only safe to use for a short time (or irregularly). Using benzodiazepines for longer than two to four weeks can lead to physical dependence and painful withdrawal symptoms when trying to stop using them. Long-term use of benzodiazepines can also lead to you feeling more anxiety, finding it harder to sleep and increasing the risk of you falling or being in an accident.

It is very dangerous to use benzodiazepines in combination with alcohol or opioids (and other ‘depressants’) as this can slow or stop you from breathing.

If you are concerned about your use of benzodiazepines, don’t stop using them immediately, because it can lead to severe withdrawal problems.

It’s important to speak with your GP and your psychologist or mental health professional about the most effective ways to stop using benzodiazepines, or to manage your anxiety or sleep problems.

There are other effective ways to manage anxiety, stress and difficulty sleeping. Further information and support is available on the following websites/hotlines:

+ Reconnexion: 1300 273 266

http://www.reconnexion.org.au/www/464/1001127/default.asp

+ Beyond Blue: https://www.beyondblue.org.au/

+ Lifeline: 13 11 14 https://www.lifeline.org.au/

Medication Dependence

Prescription medication dependence is a common consequence of being prescribed highly addictive medication for a long time.

Prescription medication dependence is a medical condition which can happen to anyone.

It is possible to become dependent on opioid or benzodiazepine medications without realising it. This is a common consequence of using these medications for longer periods of time and doesn’t say anything negative about a person’s character or moral fibre.

There are effective treatments for dependence, including reducing the medication with assistance and/or accessing counselling or medication-assisted treatment. Talk with your GP or call DirectLine on 1800 888 236 if you are concerned about your medication use.

Further information and support is available on the following websites/hotlines:

+ SafeScript Pharmaceutical Helpline (24/7): 1800 737 233

Free and confidential advice, support and referral for people concerned about their use of medicines.

+ Reconnexion (9-5pm): 1300 273 266

Support for people experiencing anxiety disorders, depression and benzodiazepine dependency.

http://www.reconnexion.org.au/www/464/1001127/default.asp

+ Family Drug Support (24/7): 1300 368 186

Family Drug Support provides non-judgmental, non-directive support and information for families and friends of drug and/or alcohol users across Australia.

+ Counselling Online (24/7): http://www.counsellingonline.org.au/

Counselling Online is online text-based counselling for people concerned about alcohol and other drug use. The service is also available to people concerned about a family member, relative or friend.

+ Lifeline (24/7): 13 11 14 https://www.lifeline.org.au/

Get Involved

There are many ways you and your organisation can get involved in or support the One Too Many initiative.

Here are three key ways you can be get involved:

1. Host a lunch and learn

Hold an event to raise awareness about prescription medication related harms at your workplace. Download the ‘Community Toolkit’ here to find out more or get in touch using the form below.

2. Engage on social media

Follow ScriptWise on our Facebook or Twitter pages to learn more about One Too Many activities or join the conversation using the #OneTooMany hashtag

3. Show support in your workplace

Print out and put up a poster at your workplace to ensure your colleagues know the risks of using prescription opioids and benzodiazepines long-term. Please use the form below to request a poster or resources for your workplace.

Get in touch!

Let us know what activity or how you would like to be involved in the One Too Many initiative.

Information for Health Professionals

There are a number of resources health professionals can access to find out more about treating underlying conditions which may have caused prolonged use of the medicines in the scope of SafeScript, and to assist to effectively treat prescription medication dependence.

SafeScript

Visit the Department of Health’s SafeScript website

+ Preparing for SafeScript

+ FAQ for Health Professionals

Chronic Pain

+ NPS free accredited CPD activity: Chronic pain: opioids and beyond. Supporting a multimodal approach

+ NPS free accredited CPD activity: Chronic pain: opioids and beyond. Case study

+ Pain Australia’s Clinical Assessment of Pain

+ Pain Management Network’s Opioid Risk Assessment

+ NPS MedicineWise’s Opioid Prescribing Decision Aid

+ Pain Management Network’s Chronic Disease Management Plan

It may be helpful to show your patient some of the resources provided by other organisations which seek to help Australians better manage their pain, such as this PainBytes website developed by Pain Management Network.

Anxiety/Sleep problems

+ Beyond Blue website ‘Resources for Health Professionals‘

+ RACGP ‘Anxiety Disorders‘

+ Centre for Clinical Interventions ‘Top 10 Patient Handouts‘

+ Centre for Clinical Interventions ‘Sleep Resources‘

Prescription medication dependence

+ DACAS provide a 24-hr help line for health professionals to ask questions of addiction medicine specialists and professional drug and alcohol counsellors. Call on 1800 812 804

+ Call Reconnexion on 1300 273 266 to request information, resources or secondary consultations

+ ScriptWise’s ‘Dependence and Addiction’ section of the Prescriber Toolkit provides many resources to assist health professionals in treating prescription medication dependence

+ The Department of Health and Human Services also offers free training for medical practitioners, nurse practitioners and pharmacists who wish to be involved in the pharmacotherapy program. Find out more about registering for training with the RACGP or Pharmaceutical Society of Australia here.