Prescription drug abuse – A large and growing problem with a very simple solution
In September 2010 a 40 year old West Australian mother of 7 died from an overdose of Methadone that had been prescribed to prevent her continuing to abuse prescription drugs including Valium, Stillnox (a sleeping pill) and ‘over the counter codeine preparations’. Her autopsy revealed that ‘methadone was found at fatal levels and promethazine (commonly found in fenurgen) was found at toxic levels’.
The West Australian Coroner concluded the doctor treating her appeared ‘to have acted in a very professional manner and communicated with her regular pharmacist with a view to limiting her abuse of these medications. Ms X was put on the methadone program with a view to harm reduction and efforts were made to limit her access to drugs through her pharmacy’.
Her brother in law believes the fundamental problem was that she did not have a doctor and a pharmacy but that she and other members of her family had many doctors and many pharmacies, via which they regularly received an array of taxpayer subsidised (via the PBS) abuse-able prescription drugs. As responsible as each of these individual doctors and pharmacists may have been, none of them had any way of knowing who else was prescribing or dispensing abuse-able drugs to these motivated doctor and pharmacy shoppers.
The tragedy of this woman’s death is not just that she left seven motherless children, but also that it was entirely predictable and easily avoidable. Over a year before the woman died her brother in law began a one man crusade to alert police, government authorities, doctors and pharmacists of the frequent doctor and pharmacy shopping by members of his family. However, in the absence of a system of collating information about the prescriptions written and dispensed nothing was, or arguably could have been done.
The good news is the solution is simple. All prescription drugs are dispensed by pharmacists. The Commonwealth and State governments need to co-operate and remove privacy restrictions so that pharmacists can share information about what drugs have been dispensed to individuals presenting prescription in their pharmacies. This change and a modest investment by government in the software needed to allow the ‘real time’ sharing of information between pharmacists will shut off the pipeline of abuse-able prescription drugs that is fuelling this misery. No patient with a genuine therapeutic need will be denied medications. Only patients who are continuously using prescription drugs faster than at the recommended dosage would be denied.
This solution will save lives as well as taxpayers money. Millions of taxpayers’ dollars that currently subsidise pharmaceutical abuse and addiction via the Pharmaceutical Benefits Scheme can be redirected to therapies that help not kill. I first called for this reform in early 2009. Lenette Mullen, President of the Pharmaceutical Society of Western Australia has been calling for this type of reform for even longer. And now the Western Australian Coroner Alistair Hope has become aware of ‘other similar cases’ which ‘highlight the need for there to be a central register for all medications which would record all scripts written’ for abuse-able prescription drugs.
In summary this mother of seven died from an overdose of a prescription drug prescribed to prevent her abusing other prescription drugs and according to the WA Coroner this is not an isolated case.That is an absurd situation particularly when there is a very simple solution to this large and growing problem. Now that the West Australian Coroner has joined the chorus for reform, surely governments will act.
Note: All quotations are from a letter to me, Martin Whitely MLA, from the State Coroner of Western Australia, Alastair Hope dated 15 August 2011
Martin Whitely MLA
Author Speed Up and Sit Still