Dr Gabrielle Campbell, NHMRC Australian Public Health Early Career Fellow at NDARC, UNSW.
In the last twenty years there have been substantial increases in the use of pharmaceutical opioids in many countries, including Australia which has one of the highest levels of opioid utilisation globally 1. Almost 15 million opioid prescriptions were dispensed in 2015 and our use of high-potency opioids has also increased 2. One of the main drivers is the increased use of prescription opioids for chronic non-caner pain (CNCP) 3. In parallel to escalating use, opioid-related harms have also increased. Since 2000, there has been a shift in both hospitalisations due to opioid poisonings and opioid-related deaths, from predominantly heroin to pharmaceutical opioids4. Extra-medical use (defined as any use of a medication outside the formal medical system or inconsistent with a doctor’s prescription5) is also relatively common; the most recent household survey indicates ‘non-medical use’ (the terminology used in this survey) was reported by 4.8% of the Australian population4.