Why is prescription medication misuse becoming a problem in Australia?
The Issue
The misuse of prescription medication is a health emergency in Australia that’s affecting many families and individuals.
According to the AIHW, about 1 million Australians reported recent non-medical use of a pharmaceutical medication.
Few Australians know that prescription opioids are responsible for approximately 70 percent of accidental opioid-related deaths, making them a bigger killer than heroin.
What we do know is that too many Australians are dying due to prescription medication overdose.
According to the Penington Institute’s 2017 Overdose Report, in Australia 1,737 people aged 30-59 died from a pharmaceutical opioid overdose between 2011 and 2015.
In Victoria alone, the number of people lost to pharmaceutical drug overdoses exceeds the road toll and has done for the last 5 years.
Which prescription medications are causing the problem?
Prescription medications have an essential role in health care. However, when these medications are accidentally or intentionally misused, their effects can be very dangerous and even fatal.
Opioid and benzodiazepine medications are primarily responsible for the increasing number of overdose fatalities in Australia.
Find out more about prescription opioids and benzodiazepines
Opioids
Pharmaceutical opioids are medications commonly used for pain. According to the National Drug and Alcohol Research Centre, opioids are depressants which modify the activity of the central nervous system and messages going between the brain and body. Common opioid medications include:
+ oxycodone (e.g. OxyContin, Endone or Targin)
+ codeine (e.g. Panadeine Forte or Nurofen Plus), and
+ fentanyl (e.g. Durogesic, Fentanyl Sandoz Patches)
Opioids have an important role in surgical pain, end-of-life care and some severe short-term painful conditions. They have very limited to no role in ongoing pain conditions where other strategies are more effective and/or more safe to use.
Benzodiazepines
Benzodiazepines or ‘benzos’ are a sedative medication. They are often referred to as sleeping tablets and usually prescribed for anxiety problems and insomnia. According to the National Drug and Alcohol Research Centre, they have anxiolytic (anxiety-reducing), sedative and muscle relaxant effects. Common benzodiazepines include:
+ diazepam (e.g. Valium or Diazepam Intensol)
+ temazapam (e.g. Temaze or Normison, and
+ alprazolam (e.g. Xanax, Ralozam or Kalma)
Benzodiazepines have a limited role for some short-term issues, but like opioids, are best to avoid as ongoing treatment.
Taking benzodiazepines with other drugs (such as alcohol and opiates in particular) can be dangerous and result in breathing difficulties and increased risk of overdose and death.
More questions about prescription medication dependence? Read through the following frequently asked questions
Commonly Asked Questions
Who can become dependent on or addicted to pharmaceutical opioids or benzodiazepines?
The short answer? Anyone.
Dependence and addiction are health conditions that do not discriminate. This means that it is possible for you, a family member, friend, neighbour or work colleague to become dependent or addicted to these medications.
About 1 in 10 Australians who recently used opioids or benzodiazipines for non-medical purposes said they couldn’t stop or reduce their use, even if they wanted to. People with an addiction lose control over their medication use, often despite their desire to cut down or stop altogether.
According to Dr Suzanne Nielsen from the National Drug and Alcohol Research Centre, we know that compared with people in treatment for heroin dependence a decade ago, people in treatment now are more likely to be older, employed, female and have a history of chronic pain. People with mental illness and a history of trauma are also more likely to have recently used a pharmaceutical for non-medical purposes.
If you answer yes to any of the below questions, you may be at risk of dependence and it’s important to speak with your GP.
– Do you find that you’re taking more than the prescribed dose of opioid medication to treat your pain or anxiety?
– Do you feel that you’re having to go back to your GP frequently to get the amount of medication you need?
– Do you feel that your pain and mood get worse if you don’t take your medication?
– Do you feel judged or ashamed when your pharmacist or GP wants to discuss how much medication you are buying or using?
– Do you begin to feel highly anxious about not being able to get your medication and that you need it to function in daily life?
Opioid dependence is a medical condition that can happen to anyone, and there is no shame in seeking treatment for it. Have a listen to some personal stories here.
If you answered yes to any of the above questions, ask your GP about the many very effective treatments available.
How does prescription medication dependence or addiction happen?
People who have been prescribed these medications by their health professional can become dependent or addicted to using them, particularly if they’re using them regularly or for a long time.
A family or personal history of alcohol or other drug problems, history of abuse or co-existing chronic pain or undertreated mental health conditions can increase the risk of dependence or addiction.
It is possible to become dependent on opioid or benzodiazepine medications without realising it. The body can develop a tolerance which lessens the medication’s effectiveness and means more and more is needed to get the same effect. When use stops suddenly, withdrawal symptoms can occur such as:
+ head and muscle aches
+ mood swings
+ insomnia
+ nausea
+ diarrhoea
It’s important to talk with your GP or another medical professional if you think you may need help. Your health professional can help you arrange a thorough assessment of what you’re experiencing, and tailor a treatment plan to help. They can also help to reduce the risks associated with using opioids and benzodiazepines.
You can also listen to personal stories about the recovery process here.
What are the treatment options?
It’s really important to start a conversation with your doctor or pharmacist if you are concerned about your opioid or benzodiazepine use.
There are a number of different ways to treat dependence on these medications, and they are treated in a similar way to other long-term health conditions.
Treatment options may include:
+ Medication-assisted treatment
+ Counselling
+ In-patient or residential treatment programs
+ Detoxification (with medical guidance)
If you think you may have a problem with your medication use, have a talk with your GP or pharmacist. Some examples of what you might say are:
+ I am concerned about my health due to my opioid/benzodiazepine use
+ I think I may have become dependent on my opioid/benzodiazepine medication. Can you please help me understand what I can do next?
It can also be really helpful to have support from family and friends if you’re concerned about your health. Talk with someone you trust about what’s happening, or invite them to come to the doctors with you.
Here’s what Joeleen, a young woman with lived experience of codeine dependence, had to say about seeking support:
“I feel that it’s important for people with addiction who want to get help to reach out and speak to a trusted family member, loved one or friend about it.
I found for me it really helped me to open up and let them know what I was going through. Having their support and understanding really pushed me to try harder to get through it and it also made me feel less alone when I knew I could talk about it without being judged.
I feel having that ongoing support is vital in helping you get through your recovery. I haven’t had painkillers in over six months and I still need that occasional “You’re doing great Joeleen” or “How are you coping with the pain?” etc. It makes you feel good and having that positive ongoing support reminds you why you started the journey to recovery in the first place.”
You can also call a helpline if you would like more information about what resources are available and to speak to someone confidentially. Visit our ‘Get Support’ page to find out more.
Addressing prescription medication misuse, dependence and addiction