Mon, Sep 09, 2019 - Page 7 News List

Opioid crisis goes global as deaths surge in Australia

Canberra says it is now taking the problem seriously as calls go out to heed the warnings provided in the US

By Kristen Gelineau  /  AP, BLACK RIVER, Australia

A doctor prescribed her opioids to ease her pain. When she stuck the first patch on her skin, it felt like heaven.

However, the agony eventually returned, so the doctor increased the dosage. The side effects were hell — depression, anxiety, panic attacks. And her pain got worse.

Desperate, she saw other doctors. They sent her away with more prescriptions for more opioids: fentanyl, codeine, oxycodone, tramadol, buprenorphine, tapentadol, Targin.

An estimated 20 percent of Australians suffer chronic pain, but in poor, rural areas, access to pain specialists can be logistically and financially difficult. Wait lists are long and a few sessions with a physiotherapist can cost hundreds of dollars. Under the government-subsidized prescription benefit plan, a pack of opioids costs as little as A$6.50 (US$4.50).

Tim Andrewartha, a general practitioner in northwest Tasmania, says giving a patient with chronic pain a drug for quick comfort can be tempting, when the alternative may be a years-long wait to see a specialist.

“As a medical practice, we’re just falling short in terms of acknowledging the lack of evidence that these drugs have for chronic, long-term use,” he says.

Casey could not afford private health insurance, so finding a surgeon who would treat the cause of her pain was a struggle. She drove 10 hours roundtrip to meet a surgeon in the state capital, Hobart, only to be told that the wait list for the operation was two years.

While taking a truck driving course, she injured her shoulder and began the same carousel of fruitless doctors’ appointments.

She tried to quit the painkillers. She returned them to the pharmacy and dumped them down the sink. She suffered through the nightmares and shakes of withdrawal, but eventually, the pain would grow unbearable, so she would take the drugs again.

She lost her farm. Even worse, she says, she lost her daughter.

She made bad choices on the drugs, she admits now. She was living with a volatile man who began to bully Sarah, so she sent her daughter, then 14, to live with her father. It is a decision that tore them apart and still tears Casey apart today.

One day, she scrawled her anguish on a tattered envelope.

“Imagine having a toothache for weeks, months, one year, two years, three, four, and it’s still aching now ... the pain eats away at you, the drugs send you crazy,” she wrote.

In June, she told herself: Enough. She returned the remaining pills to her pharmacist.

She found a surgeon who took her seriously. And she got an appointment with a physiotherapist who is teaching her exercises to manage her pain.

On a recent afternoon, she rifles through a box of medicine in her kitchen. Suddenly, she freezes. Tucked inside is an old pack of tapentadol that she thought she had thrown away. She washes the pills down the kitchen sink.

She does not know what she will do when the pain returns, but she says she will never return to opioids.

“I’m not going back,” she says and begins to weep. “I’m not.”

The conclusion from King, the coroner, was blunt: Had a prescription tracking system been in place, Matthew would not have been given the oxycodone that killed him.

King’s findings on Matthew’s death were delivered at least a dozen years after the first coroners’ reports began warning of a growing opioid problem. As early as 2007, a coroner had suggested that someone look into why the opioid prescription rate on the island of Tasmania was so high.

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