Number of Australians dying from overdose on the rise

New research has shown that there has been an increase in the number of Australians who die from unintentional drug overdose each year.

The Penington Institute has released its Australia’s Annual Overdose Report 2019, which monitors drug-induced deaths across Australia.

It concluded, among other things, that there is an “urgent need for action” as Australia’s overdose risk profile continues to diversify.

There has been a sharp rise in deaths involving stimulants (including methamphetamine) in Australia since 2012, the report said, which is seen in both regional and urban areas.

“Deaths involving other prescription medications – such as anti-convulsant medications, used as treatment for neuropathic pain, and anti-psychotics – have increased markedly in the last few years, although they account for only a small proportion of all unintentional drug-induced deaths,” it said.

“Drug-induced death is not confined to either illegal drugs or those taken as medicines; alcohol may also be involved in unintentional drug-induced deaths. When used in conjunction with other drugs, alcohol may contribute to a fatal overdose, or, rarely, be the sole cause of an unintentional drug-induced death. Up until recently, alcohol was the third most common drug involved in unintentional drug-induced deaths, though it has recently been surpassed by stimulants.”

While a single drug may be identified in an unintentional drug-induced death, it is rare for a death to be attributable to toxicity from a single drug, Penington wrote.

Deaths involving multiple drugs are the norm rather than the exception, it surmised, with poly-drug deaths involving four or more substances increasing significantly in recent years.

Elsewhere, while drug use is commonly associated with younger people, the report revealed that it is middle-aged Australians (30-59 years old) who have the highest incidence of unintentional drug-induced mortality.

“Further, the gap between this middle-aged cohort and Australians under-30 or over-60 has expanded in the last 15 years and continues to widen,” it said.

“Unintentional drug-induced deaths overall are more prevalent among men, with the number of deaths for males increasing more rapidly than for women in recent years. Similarly, the rate of unintentional drug-induced death remains higher for Aboriginal Australians than for non-Aboriginal Australians, and this gap is widening.”

“Finally, unintentional drug-induced deaths occur across all socioeconomic areas, with small differences in prevalence observed between the most advantaged neighbourhoods and the most disadvantaged neighbourhoods.”

Drugs and overdose also tend to be associated with urban areas, Penington wrote. However, the data revealed that the highest growth in unintentional drug-induced deaths is occurring in regional settings, away from capital cities.

“This trend poses significant challenges for responding to overdose, as regional areas tend to have less access to drug treatment and support services and may have longer delays in ambulance attendance,” it surmised.

“There were 1,612 unintentional drug-induced deaths in Australia in 2017, accounting for almost three-quarters (74.6 per cent) of all drug-induced deaths. This equates to more than four unintentional drug-induced deaths per day in 2017, or one death every 5.4 hours. It is anticipated that these numbers will rise as cases are finalised through the coronial system.”

The number of unintentional drug-induced deaths has also increased significantly over the past 15 years, from 981 in 2001 to 1,612 in 2017.
From 2001 to 2017, the population of Australia increased by 27.8 per cent, Penington outlined, and during the same period, the number of unintentional drug-induced deaths increased by 64.3 per cent.

“The increase in unintentional drug-induced deaths is more pronounced among some parts of the community. Since 2001, the number of unintentional drug-induced deaths has increased significantly among people aged 30-59 (from 540 to 1,154 in 2017, an increase of 113.7 per cent), but has decreased among those aged under 30 (from 248 to 151 in 2017, a decrease of 39.1 per cent).”

Speaking about the report, Penington Institute CEO John Ryan said that deaths due to unintentional injuries and mental disorders (including drug and alcohol dependence) are two of the costliest types when measured in terms of productivity loss.

“A death due to unintentional injuries has been estimated to incur a productivity loss of $595,0001. Based on the findings of this report, that means that the 1,612 unintentional overdose deaths cost our economy almost $1 billion in 2017 alone,” he said.

But, he added, the economic costs “can never adequately convey the human cost of a fatal overdose”.

“The effects of overdose are profound. Every death is a preventable tragedy that creates a years-long ripple effect,” he said.

“While every Australian whose death is recorded here can no longer tell their story, decision-makers, practitioners, researchers, family members and local communities know that we can prevent more overdose deaths.”

There is no simple solution, but, fortunately, Australia doesn’t have to start from scratch, Mr Ryan continued, saying there is “already ample evidence on how to make overdose less frequent and less fatal”.

“Community-wide and targeted education to potential overdose witnesses, expanded access to drug treatment including opioid agonist therapy, improved access to the opioid reversal drug naloxone, pain management and allied health will all help. Localised interventions for regional and rural communities that are community-led and based on partnership should also be expanded,” he explained.

“Initiatives like real-time prescription monitoring might help, if they’re implemented in a way that increases, rather than restricts, access to health services. If we just rely on supply-side interventions, patients may attempt to treat their pain or withdrawal symptoms with illicit opioids like heroin.”

Last week, Wellness Daily reported that the Australian Physiotherapy Association called on the government to invest in true multidisciplinary pain management services – physiotherapy in particular – to avert the health crisis and stop these unnecessary deaths.

Penington Institute compiled the report based on data from the Australian Bureau of Statistics.