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A nation in pain

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Australians are world champion pill poppers, quadrupling their use of common opioid-based painkillers such as codeine, morphine, and oxycodone in the last decade, an international study has found.

Researchers from the independent body responsible for implementing the United Nations international drug control conventions, the International Narcotics Control Board, found that the use of opioid painkillers in Australia rose from 22 million doses annually in 2001 to 106 million doses annually in 2013.

Though there has been a worldwide trend toward greater reliance on painkillers, Australia is one of a handful of regions that accounted for the vast bulk of increase in their use.

The INCB study, which examined the consumption of the painkillers, and the prevalence of disorders that needed them, in 214 countries, found that overall opioid painkiller use had doubled since 2001. But Australia, North America, Western and Central Europe and New Zealand accounting for more than 95 per cent of global opioid use.

While researchers speculated the higher usage in developed countries could be due to increased pain management for cancer in aging populations and other chronic illnesses, low-income and developing countries, which have higher rates of the diseases for which opioid medications are needed, had little access to the drugs, and there was no significant increase in their use.

Co-author of the study, Professor Richard Mattick, from the University of New South Wales’ National Drug and Alcohol Research Centre, said that there were a number of factors that made it difficult for patients in in developing countries to get painkillers, particularly cost, but also including a lack of training among medical professionals and fear of dependence.

Professor Mattick told The Guardian that because there was no recognised level of appropriate prescribing and dosage for opioids, it was hard to tell if their use in Australia was excessive or inappropriate.

“You can’t have benefits without some harms; it’s just nonsense to think otherwise,” Professor Mattick said.

“So, while it’s correct to bring attention to harms, I think we have some work to do to understand this situation accurately, and to get a comprehensive national picture of what is driving this use.”

The study was published in the Lancet.

Kirsty Waterford

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