Annual Overdose Report 2020: Guest piece by John Ryan, CEO Penington Institute

Penington Institute’s Annual Overdose Report 2020, released on International Overdose Awareness Day, has revealed that close to 11,000 Australians have died of overdoses in just five years.

Applying the Australian Government’s own estimate of the value society places on a year of life ($213,000) means that, conservatively, overdose deaths cost our economy more than $13 billion a year. The costs to families and communities are, of course, incalculable.

It is a national tragedy which claims more Australian lives than road accidents and melanoma.

Overdose is not a fussy killer. It comes for our loved ones without much regard to their place in the hierarchies of income but is worse per capita in regional Australia than the capitals.

Most drug problems start with trusted people – the doctor, pharmacist, older siblings or friends.

The drugs most implicated in overdose are often prescribed after a trauma, physical or mental. Even those who start off wanting to alter their perception non-medically often get their taste from friends or family, especially older siblings.

The numbers clearly indicate that our national approach is not working. We cling to a supply control approach which disempowers communities and individual knowledge and action.

The War on Drugs, continued with little regard to its failures, has continued unabated, wasting money and eroding liberties while our loved ones are dying.

But there are prevention strategies and responses which will save lives while being cost-effective and respectful of human dignity.

An easy win is for the Commonwealth to immediately expand its pilot of community access to naloxone (an opioid overdose reversal drug) from New South Wales, SA and WA to all states and territories.

Health professionals need to treat drug risks and addiction as a health issue just as much as governments need to. It is a mainstream problem and there are terrific new long-acting opioid substitution treatments in the market (a true innovation) but, ironically, not enough engaged health professionals to supply them to those in need.

We must be cautious with real-time prescription monitoring, a technological ‘fix’ to a deep-rooted social and health problem that can lock people out of the getting the care they need. What monitoring and evaluation will be applied, especially as we already know it can have perverse consequences, like lack of access to proper pain management and people shifting to illicit drugs.

Unfortunately, governments continue to privilege law enforcement supply side solutions even though much of our challenge is in the health sector, from improving pharmaceutical drug patient management and mainstreaming addiction issues in primary care.

The drug crisis in Australia will continue to evolve as increasingly dangerous drugs become more common. Overseas, batches of heroin are increasingly mixed with fentanyl, an extremely powerful synthetic opioid, easier to produce and traffic than heroin and manufactured in industrial quantities on our doorstep.

With more than 10,000 Australians dead in five years, it is time to acknowledge that our approach has failed and to finally trust people by investing in knowledge about licit and illicit drugs, improving chronic pain care including access to essential pharmaceutical relief, and developing a comprehensive national strategic approach to overdose.

$13 billion every year is a huge cost – but not as great as the awful grief thousands of Australians families are saddled with, often in silence.

John Ryan
CEO, Penington Institute