A study by UNSW’s National Drug and Alcohol Research Centre has found the number of Australians receiving treatment for dependence on the painkillers codeine and oxycodone trebled between 2002 – 2011.
The research found of those people in treatment for opioid dependence, one in five were being treated for dependence on pharmaceutical opioids – most commonly morphine, codeine, oxycodone and fentanyl.
Clients being treated for pharmaceutical opioid dependence were older, less likely to inject and more likely to be living in rural and remote areas. Although heroin is still the principal drug of concern for people in treatment for opioid dependence, prescription opioids are far more common than in 2002 when the vast majority of people (93%) were being treated for heroin dependence.
Women make up the majority of people in treatment for codeine dependence while men were far more likely than women to be in treatment for heroin and strong painkillers such as oxycodone and fentanyl.
Dr Suzanne Nielsen, who will present the research at today’s National Drug and Alcohol Research Centre’s (NDARC) Annual Research Symposium, says that there are a number of effective treatments for pharmaceutical opioid dependence, including opioid substitution therapy (methadone and buprenorphine).
“We need to adapt the way we deliver treatment given the changing profile of opioid dependence,” Dr Nielsen says.
“Compared with people in treatment for heroin dependence a decade ago, the people we are seeing now are older, more likely to be employed, more likely to be female and more likely to have a history to chronic pain.
“Some may be reluctant to come forward because of the stigma associated with traditional treatment for heroin dependence.”
In another paper to be presented at the symposium today, a study of 1,500 Australians who are being prescribed strong opioids, such as oxycodone, for chronic pain found that 40% were taking high doses (more than 90mg daily) or very high doses (more than 200mg daily) and were at high risk of becoming dependent.
Lead author of the study Gabrielle Campbell says her team found no difference in pain relief between those taking more than 200mg of oxycodone daily and those taking 90 mg daily.
“Both groups however were equally likely to become dependent, tamper with their medicines and use them other than as prescribed,” Ms Campbell says.
Those at risk for developing problems with their medication also had pre-existing mental health problems including anxiety and depression and were likely to have a history of dependence on alcohol and sedatives such as benzodiazepines.