How doctors are changing opioid prescriptions

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Over the past 30 years, there’s been a significant surge in opioid prescriptions. By 2019, Australia stood eighth in global opioid use.

Despite the role of opioids in pain management, there’s been a parallel increase in opioid-related deaths.

Between 2007 and 2016, opioid-related fatalities in Australia doubled, mostly attributed to prescription opioids.

Australian Interventions

PBS Changes (June 2020): The government introduced changes to the Pharmaceutical Benefits Scheme, altering opioid prescription practices. This involved reducing opioid pack sizes and revising prescription guidelines.

Prescription Monitoring Programs: All Australian territories and states have adopted these programs to reduce opioid-related risks by alerting healthcare professionals about potential misuse.

However, the impact of these programs remains unproven, with a recent study suggesting no significant change in high-dose opioid prescriptions post-introduction.

Opioid Dependence Treatment Program: This program has been modified to subsidize medicines for opioid dependence treatment.

While the change reduces costs for over 50,000 Australians, some providers argue that the rushed implementation may reduce the availability of treatments.

U.S. Experience

The U.S saw a significant decline in opioid prescriptions post the introduction of monitoring systems and the 2016 CDC guidelines.

However, this led to unintended consequences, like an increase in mental health issues and opioid overdoses, especially with the surge in illicit opioid use.

The use of synthetic opioids like fentanyl led to a spike in fatalities.

Australian vs. U.S. Approach:

While both nations introduced prescription drug-monitoring programs, Australia’s strategy is health-centric, avoiding the pitfalls of the U.S law enforcement-focused approach.

There’s no significant evidence of high-dose opioid prescription reduction in Australia. Yet, individuals with chronic pain report difficulties accessing opioids.

Australia’s 2023 guidelines emphasize gradual opioid tapering and collaborative decision-making between doctors and patients, recognizing that completely halting opioids may not suit everyone.

Outlook: It remains to be seen if Australia’s distinct approach will prevent the escalation of opioid-related harm witnessed in the U.S.

The above summary provides an overview of the opioid prescribing scenario in Australia, its interventions, the U.S. experience, and Australia’s unique approach.

The goal is to offer insights into how Australia is tackling the opioid crisis and its efforts to avert the problems seen in the U.S.

If you care about opioids and pain, please read studies about what to ask your doctor before taking opioids and findings of opioid use in older people with dementia is linked to higher death risk.

For more information about opioids and health, please see recent studies about easier access to prescription opioids that may curb overdose deaths and results showing that this drug may relieve painful ‘long covid’ symptoms.

The study was published in the International Journal of Drug Policy.

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