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The journey from pain relief to addiction

(ĐTĐ) – New research reveals that Australians are consuming more prescription drugs than ever before. Among the most dangerous and addictive families of drugs are opioids, strong pain killers used for people with injuries and drug dependencies. Increasingly the drugs seem to be being abused, as Shevonne Hunt writes.

Simon Millington did not have a history of drug abuse when he was first prescribed pain killers. He was 18 when he was in a terrible car accident and was in hospital for three months, with eight days on life support.

The journey from pain relief to addiction


At the time his family saw the drugs being prescribed to Simon as a necessary part of his treatment. They had no way of knowing that it was the start of a 16-year battle with addiction.

His mother Margaret said that Simon needed powerful opioids like Oxycontin after his accident, but that over time he stopped knowing the difference between pain and addiction.

At that point he would drive long distances from his home in Western Victoria—to South Australia and New South Wales—in order to get more prescriptions.

Margaret says that Simon didn’t even enjoy being on Oxycontin.

'Simon hated being on it because it took away his soul, and it did, he had everything to live for.'

'He was powerless over his addiction. Even the fact that he had a little girl, he had a loving, caring family, he had a meaningful life: he still reverted back to that addiction and in the end he succumbed to that.’

Simon died from an accidental prescription drug overdose in 2010.

He's part of a growing trend in Australia for the prescription of strong pain-killing drugs, many of which seem to be being misused by doctors and patients—leading to addiction and death.

Professor Paul Haber decided to look into prescription medicine after seeing the result of their misuse at the emergency department of the Royal Prince Alfred Hospital in Sydney.

‘At our hospital we have been seeing an increasing number of people with overdoses … and [we were] surprised at the range of medications being taken,' he says.

Four years ago he started looking into the Pharmaceutical Benefits Scheme (PBS) data on opiate use and was alarmed at the increase in prescription of several powerful drugs. Opioids are used to treat chronic and acute pain, and to treat people with drug dependencies.

In research he is presenting to the International Narcotics Research Conference this week, he shows that the rise in use of oxycodone has continued over the last three years, and he says it’s not going to slow down any time soon.

Professor Haber has also found an increase in the use of two other drugs, fentanyl and buprenorphine, which he says are beginning to rival the use of oxycodone. ‘Instead of having an epidemic of one prescription opioid we’re in the midst of an epidemic of three.’

Professor Haber says that the way we currently treat chronic pain doesn’t appear to be working.

‘It was alarming that in a period where we’ve got sky-rocketing use of pain killers we seem to have higher complaints of pain. So our strategy, whilst it’s very important to treat pain, our strategy doesn’t seem to be working.’

Professor Louisa Degenhardt is leading research into the use of opioids to treat non-cancer related chronic pain at the National Drug and Alcohol Research Centre.

She’s been interviewing people who have had an average of five years of opioid use. Although her study is still in its early days, she says given that one in ten meet the criteria of dependence there are already signs that addiction is a significant problem with chronic pain.

‘We’re all getting older, the Australian population is getting older,' she says. 'We can only expect chronic pain to become a larger problem in Australia.’

But no one is currently sure how many patients are using opioids because of pain, and how many are simply addicted to the drugs.

Simon Millington’s family now believe that the best way to help people is for Australia to adopt a real-time reporting system.

Last year the Federal Government committed five million dollars to set up the Electronic Recording and Reporting of Controlled Drugs (ERRCD), a real-time reporting system designed to automatically collect the details of all prescriptions of controlled drugs and store it on a common database.

This would prevent people from ‘doctor shopping’ and getting more prescriptions to feed their addiction.

At the moment the system appears to be stalled. Professor Degenhardt says that the real issue will be paying for the system to be implemented across all the states and territories.

But the real-time reporting system will not solve all the problems of opioid misuse. Professor Degenhardt says that we need to look at the details behind the data.

‘I think it’s important to remember that some of these overdoses are suicides, they’re not accidental overdoses so it’s really highlighting the issue that there’s a lot of co-existing mental health issues.’

Professor Haber says that there needs to be more research into effective treatments for chronic pain, and that we need to look at prevention, early intervention and treatment.

‘Chronic severe pain and drug dependence is the end game of a range of serious chronic problems,' he says.


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