Hunter hooked on 'hillbilly heroin'

‘‘HILLBILLY heroin’’ and other prescription painkillers are being consumed at alarmingly high levels in the Hunter, costing up to $5.6million in government subsidies a year.

The addictive medications are being doled out at a rate of 311 scripts per 1000 people, 56per cent higher than the national rate of 199 per 1000 people, Medicare Australia data reveals.

Hillbilly heroin is the colloquial name given to oxycodone, a strong narcotic pain reliever brand-named Oxycontin. Other prescription opioids include morphine, pethidine, codeine and hydrocodone known as as MS Contin, Endone, OxyNorm and other brand names.

Along with higher rates of consumption come higher rates of problematic use,  veteran drug and alcohol expert Dr Alex Wodak says.

‘‘However this is looked at, there is a relationship between how much consumption there is of prescription opioids and how many problems you can expect to have,’’ Dr Wodak said.

‘‘We see in areas where it’s been looked at that doctors who prescribe more heavily than other doctors are more likely to have more casualties amongst patients.

‘‘For those sorts of reasons those of us who are concerned about this problem think that we need to be much more cautious about the way we deal with opiates in people who have chronic non-cancer pain,  and much more discriminating.’’

That applied to  how much, and for how long drugs of addiction were prescribed, Dr Wodak said.

Hunter-based experts agree, saying a much more conservative approach to prescription opiates is needed.

Dr Simon Holliday, who works in general practice and addictions, said a recent survey of general practitioners in the Hunter found fewer than one third of respondents followed more than half the guidelines for prescription opioids ‘‘most of the time’’.

‘‘What is surprising is that there isn’t a bigger problem,’’ he said.

‘‘We have a system oriented towards pumping these things out. I think a good point to keep in mind is that while opioids are essential medications, it is unclear if they are safe or effective in long-term use.’’

 Hunter Medicare Local chief executive Dr Mark Foster said that while most people used prescription opiates appropriately, a small number did not.

‘‘Some of them go around to multiple doctors to try and get larger supplies,’’ Dr Foster said.

Others become unwittingly addicted after being prescribed opiates for legitimate reasons.

Many people misunderstood the risks and limitations associated with the use of opiates to treat non-cancer related chronic pain, Dr Foster said.

Pain: a war others  don’t understand

THE CHEMIST

IT starts with Panadeine Forte and Nurofen Plus, or Mersyndol for an acute injury.

Time passes, and the drugs don’t seem to work as well as they used. 

Up goes the dosage, Panadeine Forte is replaced with something stronger.

Soon there are not enough tablets per prescription to get through the days.

Newcastle pharmacist Donna McKinnis says it is an all-too common tale.

For one client,  a cancer diagnosis put him on the path to opioid addiction.

He was 15, and it was bone cancer. There was surgery, chemotherapy and then analgesics (a term for painkillers).

‘‘At first he had no trouble getting the drugs off anybody, everyone felt sorry for him,’’ Ms McKinnis said.

‘‘He had cancer, he was in pain, then it sort of went on. 

‘‘He went on to heroin. Now he’s in his 30s.’’

In a week Ms McKinnis regularly sees between 10 and 15 people she is concerned about.

And often the end of the line for people who become addicted is methadone or similar substitution therapy, which people find ‘‘devastating’’, Ms McKinnis said.

‘‘You just really feel for people but at the same time it’s a much better option than what they’ve been doing.

‘‘I think the biggest issue is we do not understand pain.’’

  Gabriel Wingate-Pearse 

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