To investigate effective public health policies for preventing opioid misuse

Canada
Germany
Switzerland
USA
Health and Medicine
Public Service
To investigate effective public health policies for preventing opioid misuse featured image

Opioids kill more Australians than any other drugs. Opioid prescribing has quadrupled over the past decade in Australia, paralleled by an increase in addiction, overdose, and mortality. Every day in Australia, there nearly 150 hospitalisations, 14 emergency department presentations and three deaths involving opioids. Despite sporadic attempts to reduce the harm caused by opioids in Australia, they have remained the main drugs attributed to substance-caused deaths for over two decades. 


The number-one per capita consumer of opioids in the world is the USA, and Canada is third, with Australia close behind. Germany is second. However, as the rates of addiction in Australia and North America have risen dramatically over the past decade, they have remained stable in Germany. Similarly, the number of opioid-related deaths in Switzerland has decreased by nearly two thirds over the past two decades, demonstrating the success of some of the most progressive and controversial drug policies in the world. So, what works? This was the overarching question I aimed to answer on my Fellowship. 


I met with experts in the US and Canada who have lived through the worst drug epidemic in North American history. Over 80,000 Americans died from opioid overdose in 2022 alone and without action, over a million more will die by 2029. Despite close proximity to the US, Canada is taking a different path to the US; they are confronting the problem as a public health rather than law enforcement issue, with progressive treatment and harm reduction strategies, and some provinces decriminalising drugs entirely. But by far the most innovative approaches to mitigate opioid related harms are in Switzerland, where heroin is widely prescribed, supervised drug consumption rooms are easily accessible, drug checking has been available for three decades, and importantly, law enforcement treats drug use as a public health issue. Drug prevention programs are scarce, as they simply are not needed. Germany takes a stricter approach to prescribing opioids, with medical supervision a key aspect of maintaining control - a far less liberal prescribing policy compared with Australia. 


While this project was initially designed only to examine opioid policy and practice, wider drug policy issues, such as drug decriminalisation and the involvement of policing in drug addiction, were central in all discussions and incorporated into my Fellowship findings. Australia has the opportunity to respond to our growing opioid crisis with the benefit of the experience of countries that have lived through opioid epidemics and taken different approaches. Traditional methods to confront dynamic drug problems are not working - we need to do something different. This report aims to present some of the possibilities of a different approach to tackling the opioid problem in Australia.


Fellow

Jennifer Schumann

Jennifer Schumann

VIC
2019

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