Deaths from the potent prescription drug fentanyl have rapidly increased in Australia, with a senior doctor calling the trend a “national emergency”.
A report from the National Coronial Information Service (NCIS), commissioned by Background Briefing, shows 498 fentanyl-related deaths occurred between January 2010 and December 2015.
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This figure marks an 1,800 per cent increase on the previous decade, where NCIS data records 27 fentanyl-related deaths.
The increase reflects data in the United States, where the opioid crisis was recently declared a national emergency.
Over 71 per cent of Australia’s recorded deaths were men, with the majority of deaths occurring for those aged in their 30s (37.3 per cent) and 40s (29.1 per cent).
Bastian Seidel, the president of the Royal Australian College of General Practitioners, said the figures were a “national emergency” and should prompt concern.
“Those deaths are entirely avoidable,” he said.
Overdose fatalities ‘completely unacceptable’
Fentanyl is a synthetic opioid, roughly 100 times more potent than morphine.
Historically used for the treatment of chronic and severe cancer pain, the patch form of fentanyl has been listed on the Pharmaceutical Benefits Scheme for other types of chronic pain since 2006.
Dr Seidel said some GPs, emergency doctors and specialists were overprescribing the opioid, as they wanted to make sure they were not introducing harm.
“Certainly, the opioids that are out there now are causing more harm than any good. In some cases they’re causing death — and that’s completely unacceptable,” he said.
In October, the RACGP released updated guidelines on prescribing opioids, urging doctors to prescribe only after a “comprehensive assessment” and “thoughtful consideration”.
In an undercover Background Briefing investigation, three doctors prescribed opioids to a patient with no identification or Medicare card, with no physical examination. The longest consult was just over seven minutes long.
Dr Richard Kidd, the chair of the Australian Medical Association’s council of GPs, said those doctors should be referred to the medical board.
“That lack of proper care, that departure of the normal duty of care … this is doctors behaving badly,” he said.
Currently, states and territories have a mix of systems monitoring the prescription of controlled drugs.
Since 2012, Tasmania has had a real-time monitoring program, DORA, which provides electronic patient data, including warnings if a patient exhibits drug-seeking behaviour.
But some Australian doctors receive information on a patient’s history through a fax through to their office, or do not receive it at all.
“There are doctors out there … they just have a script pad and a ledger, and that’s how they write notes,” Dr Seidel said.
He conceded this was a “massive loophole”.
‘So easy’ to get drugs
For Sandy McGivern, whose son Angus died of a fentanyl overdose in September this year, the situation is untenable.
“I don’t understand how people in medical centres can sit there and let it happen, knowing there’s a good chance that someone is going to die,” she said.
An aspiring athlete, Angus had begun to struggle with chronic pain and addiction while on a football scholarship to America.
The day before he died, Angus had been prescribed fentanyl from a clinic he had visited at least four times in 2017.
In Queensland, where he lived prior to his death, two databases currently exist to prevent over prescribing: one system alerts GPs when they prescribe controlled drugs to known addicts, the other is hotline for doctors if they suspect a patient is exhibiting drug-seeking behaviour.
Documents obtained by Background Briefing show that, over a period of three months, Angus visited 13 doctors, who prescribed him 65 fentanyl patches, despite being on both of these databases.
Ms McGivern, who now runs a support group for family members of those battling addiction, said the responsibility could not rest solely on patients.
“They don’t make responsible decisions when they have an addiction — it’s up to the doctors … pharmacists and people in a position of responsibility to stop [drug access] from being so easy,” she said.