Karen Moore’s death, according to a coroner, was both predictable and preventable.
When the 49-year-old was found unconscious at her regional Victorian home in 2010, it was the second time in a week — and the eighth time in two years — she’d ended up in the emergency room after overdosing on prescription painkillers.
This time would be the last.
Two days after she arrived at the Latrobe Regional Hospital, she still hadn’t regained consciousness.
She died of an overdose of OxyContin and Diazepam, prescribed by her doctor.
What’s shocking about Ms Moore’s death, at Morwell in the state’s Gippsland region, is how unremarkable it is.
Every year, 80 per cent of drug overdose deaths in Victoria involve pharmaceutical medicine.
There’s been a 40 per cent rise in the number of people using and possessing prescription drugs since 2014.
Ambulance call-outs for overdoses on legal medications are at a five-year high.
“We are headed for a crisis, and collectively, our heads are in the sand,” said Dan Lubman, the director of Turning Point, Australia’s national addiction treatment and research centre.
“Just look at what’s happening in the US. It’s a tragedy. Almost 1,000 people are dying from an opioid-related overdose every week, and the worrying thing is that drug overdoses in Australia are on a similar trajectory.”
“We’re probably about eight to 10 years behind where they’re at. So we mustn’t be complacent. We must look at what lessons we can learn from the US experience and make sure that we do not end up in the same place.”
Ms Moore’s drugs were prescribed by her GP, Terence Norwood, who said he was aware of at least four of her previous overdoses.
But he continued writing prescriptions for opioid painkillers, admitting that he gave in to her requests for more pills “more than I probably should have”.
Because of the limit of 20 tablets per prescription, he would write her two scripts at a time, dated a day apart.
Dr Norwood told a coronial inquest he’d been trying to reduce his patient’s dosage.
But the inquest found that his attempts were not “consistent, timely, or successful”.
“The largest number of deaths that occur from drugs in the community are from doctor-prescribed medications,” said Sam Biondo, the executive officer of the Victorian Alcohol and Drug Association.
“Pharmaceuticals are killing more people in our community than illicit substances.”
Creating new heroin addicts
This month, the Victorian Government began rolling out a Prescription Monitoring System, aimed at preventing deaths like Ms Moore’s.
It will require doctors and pharmacists to check a database before prescribing or dispensing high-risk medications.
There will also be more training and support for doctors and pharmacists, a public awareness campaign and a dedicated hotline for people concerned about their drug use.
“This is really important, because it could actually reduce the number of deaths that are happening in Victoria,” Mr Biondo said.
But he, and others, are worried that if it’s not managed properly, the system could unintentionally create a new cohort of heroin addicts.
Professor Lubman said that had already happened in the United States.
“Those who are dying are not what the community consider to be a ‘typical drug user’, but are people who became hooked on prescription drugs for pain,” he said.
“And when it’s restricted, they go for heroin.”
His peers agree.
“I’d say it’s probable that’s what will happen in Australia,” said Alex Wodak, the president of the Australian Drug Law Reform Foundation.
“These programs don’t achieve their objectives, and often they’re accompanied by severe risks.”
Laurence Alvis, from drug treatment advocacy non-profit Uniting ReGen, said the transition needed to be very carefully managed.
“When people realise that they can’t doctor-shop or get prescription drugs, they’ll be looking for the same effects they’ve been having previously, which [means] they may go back to illicit drugs,” he said.
“It’s really important that we look at what treatment options we can provide for people who are coming off prescription drugs, rather than just sort of saying, ‘Well, these are no longer available’.”
This is especially the case when people are dealing with chronic pain, experts say.
“It’s clear that the current problem has really arisen because modern pain management specialty services haven’t been available,” said Julian Rait, the Victorian president of the Australian Medical Association.
“We really need to address the chronic management of patients who suffer from relentless pain, and we need to upsize the availability of specialist care to help them.”
Drugs as ’emotional analgesics’
Professor Lubman says the community needs to have a deeper conversation about why people are increasingly turning to alcohol and drugs.
“It’s happening on a background of increasing mental health issues, a greater sense of life pressures, unstable housing, unstable jobs, less connection with families and communities,” he said.
“Whether we’re looking at prescription drugs, or alcohol, or gambling, people actively choose to do these things.
“The people who tend to get into trouble with them are people who are looking to find some relief from the stresses, pain or trauma they are experiencing in their lives. They are dealing with these challenging issues in their life that they don’t want to think about.
“They choose to use drugs to numb out the pain or mental distress”
” Drugs are essentially powerful emotional analgesics.”
“The problem with that solution, however, is that not only do they still have their original problems they were seeking solace for, but they now have a new problem, which is their addiction.”