New guide to address opioid prescription levels

The National Centre for Education and Training on Addiction (NCETA) at Flinders University has compiled a new guide for doctors on prescribing opioids. Photo: iStock.

In Australia, more than twice as many people die from pharmaceutical opioid overdose than from heroin overdose.

Many doctors are becoming increasingly concerned about their patient’s pharmaceutical opioid use and are seeking ways to reduce it.

It’s a problem that shows more people need informed medical help with their prescribed pain relief than ever before.

Clear guidance for doctors is being provided in a new publication Responding To Pharmaceutical Opioid-Related Problems: A Resource for Prescribers,  launched by the National Centre for Education and Training on Addiction (NCETA) at Flinders University.

The publication is a necessary measure to ensure that Australia does not reach the critical levels of prescribed opioid abuse that has spiralled in the US, where an estimated 1.7 million people suffer from disorders from prescribed opioids each year.

While Australia is not suffering the same catastrophic figures, it has experienced an upward trajectory in recent years, with opioid use more than doubling among Australians aged 35 to 44 since 2007.

As a result, from February 2018 medicines containing low-dose codeine (most importantly compound analgesics) were no longer available from pharmacies in Australia without a prescription.

Between 2001 and 2012, rates of fentanyl, oxycodone, and methadone deaths in Australia all increased significantly, by an average annual rate of approximately 40%, 16% and 3% respectively.

Much of the increase in opioid use has been for persistent non-cancer pain, which has increased despite evidence of a lack of long-term benefits, dose-related risks and poorer outcomes, particularly in terms of function and mental health.

Challenges remain for doctors in terms of best ways manage a reduction of patients’ use of prescribed opioids and manage chronic non-cancer pain.

“Pharmaceutical opioids are very valuable medicines. However, Australia is currently experiencing a range of harms associated with their use,” says Professor Ann Roche, Director of NCETA at Flinders University.

“We also need strategies to support codeine-dependent individuals who will no longer be able to obtain these medicines without a prescription.

“The new publication provides valuable information about how to achieve this.”

The new guide for prescribers recognises that many people currently taking prescribed opioids may need support to adopt alternative non-pharmacological or non-opioid pain relief regimes. Others may find it difficult to stop their opioid use and may need more complex treatment that will require careful consideration, planning and dialogue.

Copies of the guide are available in hard print, on USB, or from

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College of Medicine and Public Health