Declining Opioid Prescriptions Masking Soaring Dependence Risks

A recent study has shed light on a notable decline in opioid prescriptions following significant alterations to opioid listings on the Pharmaceutical Benefits Scheme (PBS) in 2020. This groundbreaking research, spearheaded by co-author Dr. Benjamin Daniels from the University of New South Wales (UNSW), marks the first comprehensive evaluation of the impact of the 2020 opioid revisions.

The key changes introduced include new PBS subsidies for smaller quantities of opioids for acute pain, mandatory authorities required for subsidizing repeat opioid prescriptions for chronic pain, and a mandatory second clinician review for pain management regimes exceeding 12 months of opioid use. Dr. Daniels emphasizes the study’s meticulous analysis of both PBS-subsidized and private prescriptions, totaling over 81,000 mg oral morphine equivalents (OMEs).

Dr. Daniels reveals, “We observed an overall 4% decline in OMEs dispensed through the PBS in the year following the policy changes.” This translates to approximately 9,000 20-tablet packets of codeine-paracetamol or 4,000 fewer 20-capsule packets of 50 mg tramadol dispensed annually.

Unrecognizable female nurse discusses dosage instructions and drug side effects withe a female patient during a home visit.

Despite this positive trend, addiction medicine experts stress the importance of normalizing and adopting clinically proven treatments for opioid dependence in conjunction with the PBS revisions. Dr. Paul Grinzi, a Victorian GP and Medical Educator, acknowledges the downward trend in opioid prescriptions as a step in the right direction but underscores the need for further action.

Dr. Grinzi highlights, “While the overall trend is promising, it’s crucial to continue improving clinical education and normalizing harm reduction measures.” He commends the Australian regulatory system for its continuous improvement but advocates for increased access to naloxone, emphasizing its potential to minimize the harm of overdose.

Dr. Hester Wilson, GP and Chair of RACGP Specific Interests Addiction Medicine, echoes these sentiments, emphasizing the importance of considering the PBS changes within a broader framework of pain management initiatives. She urges more GPs to engage in the treatment of opioid dependence and calls for systemic support to address this pressing health issue.

In light of these findings, it’s evident that while progress has been made, there is still much work to be done to combat opioid overuse and dependency effectively. With continued collaboration and advocacy, we can strive towards a healthier future for all Australians.