Over the past decade, the rate of opioid-related deaths and hospitalisations has increased in Australia. Pharmaceuticals are a significant contributing factor, responsible for 65% of opioid-induced deaths in 2016.
It is estimated that between 3% and 10% of opioid naïve patients become chronic users following the prescription of opioids in the post-operative period. Evidence suggests that it is the duration of opioid use, rather than the dose, that is the strongest predictor of misuse. One study found that a single repeat prescription increases the risk of misuse by more than 40%. In contrast, for patients that do not become chronic users, up to 80% of their prescribed opioids remain unused. This represents a considerable financial cost to the consumer and the healthcare system. However, the potential costs associated with diversion, misuse, and accidental ingestion are likely much greater if these unused medicines are not stored and disposed of thoughtfully. It is, therefore, imperative that the duration of opioid therapy is carefully considered to allow adequate pain relief while preventing the supply of excessive quantities.
OxyNorm® 5mg is now available in packets of ten capsules making it the only short-course oxycodone pack in Australia. All existing pack sizes of OxyNorm® will continue to be available. The reduced pack size of OxyNorm® 5mg capsules aligns with the options currently under review by the Therapeutic Goods Administration (TGA) to increase the regulatory control of strong opioids. While this change only affects the 5mg strength of OxyNorm®, prescribers are encouraged to limit the prescribed quantity of all opioids to what is clinically appropriate for the individual patient.
- Brat GA, Agniel D, Beam A, Yorkgitis B, Bicket M, Homer M, et al. Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study. BMJ. 2018; 360: j5790.
- Department of Health. Prescription strong (Schedule 8) opioid use and misuse in Australia – options for a regulatory response (Consultation paper). Version 1.0. Woden: Therapeutic Goods Administration; 2018.
- OxyNorm® (oxycodone) Australian approved product information. Sydney: Mundipharma. Approved October 2018.
- Roxburgh A, Dobbins T, Degenhardt L, Peacock A, National Drug and Alcohol Research Centre. Opioid-, amphetamine-, and cocaine-induced deaths in Australia: August 2018. NDARC; 2018.