With the release of the new Netflix limited series Painkiller, we are finally seeing an airing of the realities of the opioid epidemic and the economics of the pharmaceutical industry. In 2021, worldwide estimates of the number of people with opioid use disorder stood at 21.39 million. Australia accounts for approximately 31,272 people, an 86% increase from 1990. (Opioids, cocaine, cannabis and other illicit drugs – Our World in Data)
In the USA alone, the opioid-related death rate rose 795% from 1990 to 2019, that’s from 1.53 people in 100,000 to 13.69 people in 100,000. Restrictions on prescribing, availability and pharmaceutical marketing have undoubtedly helped lead to different outcomes here in Australia. Despite this however, between 1997 and 2018, the number of patients prescribed opioids increased from 28,299 to 332,307.
While the numbers are staggering, the day-to-day struggle with prescription drug abuse is exhausting and debilitating beyond measure, adversely affecting relationships, careers, and all too often ending in loss of life from overdose.
Opioids are not the only prescription drug often misused. Others include hypnotics and anti-anxiety medications such as benzodiazepines.
“There are medications available that can really help people with severe anxiety, chronic depression, insomnia and chronic pain,” says Dr Tonya Coren from First Light Healthcare in Byron Bay.
“But we also need to remember,” she says, “that anxiety, depression, sleeplessness and pain all fall into the range of normal human experience. As doctors, one of our jobs is to help our patients discern the difference between a chronic condition and the normal range of human emotions. It’s not always straight-forward. We have a duty of care to be cautious about over-medicalising or being too quick to prescribe while also remaining sensitive and compassionate towards everyone who comes through the door. “
What is drug addiction?
Alcohol and illegal drugs, such as heroin and methamphetamine are normally what we think of when we hear the term “drug addiction”. However, misuse and dependence on prescription pain- and anxiety-relieving medications has been on the rise in Australia over the past 20 years. There is a misconception that prescription drugs are safer and less habit-forming than illegal drugs. But while prescription drugs can benefit many, their misuse can lead to life-altering dependence and addiction.
Opioids, or pain-killers, are the most commonly misused prescription drug in Australia, followed closely by benzodiazepines, or depressants used to treat anxiety or sleeplessness. While drugs such as methamphetamine and cocaine get most of the media attention, illicit use of prescription drugs has been on the rise, and in 2017, more deaths were reported from misuse of prescription drugs than from illegal drugs,[i] causing prescription drug addiction to be termed the “silent epidemic”. Tightening of restrictions for prescribing and dispensing pain-killers, including codeine, has led to a drop in dispensing rates in Australia since 2018. Despite this, non-medical use of prescription drugs remains an issue of concern in Australia with a staggering 1 in 5 Australians aged 14 and over reported in 2019 to use prescribed medications for non-medical purposes daily or weekly.ii
Misuse vs Dependence
Each year since surveys began in 2017, the Royal Australasian College of General Practitioners (RACGP) has reported that the most common health issues being managed in general practice are psychological issues. This goes hand-in-hand with an increase in mental health-related prescriptions, including antidepressants, antipsychotics, hypnotics and sedatives. However, not all those who misuse prescription drugs become dependent and not all those who become dependent on prescription drugs are misusing them. There are a host of factors that influence an individual’s likelihood of forming dependence, including availability, family and social pressures, lifestyle indicators such as chronic pain and mental illness, as well as family history, personality differences and genetic factors.
Prescription drug addiction affects people from all socio-economic backgrounds. Those suffering from prescription drug addiction are all too often highly functioning, successful individuals.
Signs and Symptoms of prescription drug dependence
Drug dependence can look very different from individual to individual and from drug to drug. While some signs may be obvious, others can be well-masked. The clinical criteria (DSM-5-TR) for diagnosing substance abuse disorders include at least two of the following documented over a 12-month period:
- Persistent desire or craving the substance
- Wanting to cut down or stop but unable to manage
- Spending a good deal of time obtaining, using or recovering from use
- Taking the substance in larger doses or for longer than advised
- Neglecting other parts of your life because of substance use
- Continuing use, even when it is causing relationship problems
- Engaging in dangerous behaviour while using
- Needing increasingly more to get the same effect
- Development of withdrawal symptoms
The powerful role of family and friends
Raindrum psychotherapist, Samantha Molineux, whose specialties include trauma, addiction and relationships, believes strongly in the importance of social connection for individuals battling addiction.
“Familial support”, she says, “is highly valuable when supporting a loved one experiencing social withdrawal. As inherently social beings, our wellbeing is intricately tied to our social connections. Our social environment profoundly influences the state of our mental and physical health. When these connections are disrupted, it can trigger a survival instinct within us, potentially leading to detrimental effects on our overall wellbeing.”
Social withdrawal and relational disconnection are often hallmarks of substance abuse. Yet, close family members and friends can play a vital role in prevention and recovery.
“If social withdrawal persists and begins to impact one’s wellbeing negatively”, says Samantha, “families can play a vital role in encouraging individuals to seek support from an outside qualified professional. Familial support can facilitate this process by assisting in accessing resources and actively contributing to moving forward.”
Treatment for Prescription Drug Addiction
There is no one-size-fits-all treatment program for prescription drug addiction. Treatment programs must accommodate an individual’s particular circumstances and be responsive to each individual’s needs, while also being clinically appropriate and addressing an individual’s underlying issues. It is paramount for individuals to be equipped with the right support at the right time.
Raindrum offers bespoke treatment with a carefully selected medical team to suit the unique needs of each of its clients. Discreet, private, one-on-one programs and exclusive accommodation allows for clients to receive the support they need when they need it most. For more information, please contact the Raindrum team on 1300 007 607 or visit us at www.raindrum.com.au.