110 The Australian Women’s Weekly|JUNE 2018
PHOTOGRAPHY OF RUSTIE LASSAM: GIOVANNI LOVISETTO. NEWSPIX.Investigation
family, went to church every Sunday
and did Meals on Wheels with Mum,”
says Rustie, dispelling the stereotype
of an opioid addict.
Her “rock bottom” moment was
when she found herself in the shower
rubbing her pregnant belly, and
apologising to her unborn son for all
the damaging drugs she was putting
into his bloodstream.
“I know what a baby needs for
healthy development, yet I couldn’t
stop myself,” Rustie, now 56, tellsThe
Weekly. “It was horriic. The drugs
came irst, second and third.”
Bee Mohamed is the chief executive
of ScriptWise, a not-for-proit
organisation dedicated to preventing
prescription drug misuse. She says
many of us take a casual approach to
painkillers because a trusted medical
professional typically gives us the
script. “But up to 30 per cent of
people who use opioids for more
than 10 days are at serious risk of
becoming dependent,” she warns.
With dependency comes addiction
and, in some cases, death. According
to the Penington Institute, there were
1137 fatal accidental drug overdoses
in Australia in 2014, up 61 per cent
on 2004, with prescription painkillers
(like oxycodone, morphine and
codeine) responsible for 411 of those
deaths and prescription relaxants (like
Valium or Xanax) killing 438 people.
By contrast, ecstasy and amphetamines
were linked to 188 of those deaths.
To put the problem into context,
the number of people dying
accidentally from prescription drug
overdoses surpasses the road toll in
Victoria. “If this many people were
dying from asthma or acute
appendicitis we would be calling it a
national emergency,” says Dr Wilson.
Yet the volume of opioid scripts
written by our doctors keeps growing
as the drug is prescribed for an
ever-increasing range of conditions,
such as endometriosis, back pain or
osteoarthritis (despite limited evidence
of eficacy). About 20,000 doses of
prescription opioids are prescribed for
every one million people every day
in Australia, putting the country at
eighth among the world’s top 30 users
of prescription opiates. This compares
with 50,000 doses of opioids
prescribed per one million people every
day in the US, where a staggering 142
people die daily from accidental
overdoses of prescription opioids.
“The doctors give them out like
lollies,” says Rayleen Fagan, a mum-
of-ive from Melton in Victoria, her
rage crackling down the phone line.
“Just last week, I had surgery for
a back problem and the doctor
prescribed me [the opioid] Endone.
Had I listened to him, I would have
a back problem and a drug addiction.
But luckily I have the knowledge.”
Rayleen’s knowledge is hard won.
For 25 years, she watched her sister,
Anne, battle a chronic addiction to
codeine, an active ingredient in
Panadeine Forte and Nurofen Plus.
Anne would spend her days doctorto medicine, particularly in the
management of cancer and acute
pain from surgery and injury. “But
the beneits of these drugs tend to
be overstated and the risks of
addiction grossly understated,” warns
Dr Wilson. She argues that addiction
should be classiied as a predictable
side-effect of opioids, in much the
same way as rashes, vomiting and
diarrhoea are.
“Addiction is not an indication that
the individual is a bad person or
immoral. It’s just the way our biology
interacts with this medication,” says
Dr Wilson. “We need to remove the
stigma and know that this could
happen to anyone. It could happen to
you, it could happen to me.”
In an opinion piece inThe Lancet
medical journal last year, Stanford
University’s Keith Humphreys urged
developed countries like Australia to
learn from the mistakes of the United
States, where about 60,000 people die
each year from prescription opioid
abuse – more than the number who
died in the Vietnam War.
“Countries should immediately
strengthen all available safeguards
against the globalisation of the
prescription opioid addiction and
overdose epidemic,” Humphreys said.
“Central to such efforts should
be the formulation of prescription
practice guidelines, the development
of relevant legislation and regulation,
thetraining of medical professionals,
the creation of putatively public
health-orientated activist groups
and the certiication of heathcare
facilities.”
Yet much of what has been done so
far in Australia to arrest the opioid
epidemic has merely tinkered around
the edges of the problem.
Tasmania and Victoria have both
committed to introducing a system
of real-time prescription monitoring
which allows doctors to check a
patient’s immediate prescription
history, preventing the practice of
doctor shopping. ScritptWise’s Bee
Mohamed says these are important
irst steps, and that other state
governments need to see prescription
monitoring “as a long-term investment“Weneedto
remove the
stigma and know
this could happen
to anyone.”
shopping, she would feign headaches
in order to raid her friends’ medicine
cabinets, and her relationship with
Rayleen and other family members
broke down as they begged her
doctors to stop prescribing the drugs.
The battle ended six years ago.
“My sister went to sleep on the
couch on Christmas Eve and never
woke up,” says Rayleen. “Her body
was full of prescription medicines.”
Today, Rayleen will take only half a
Panadeine Forte when the pain from
her back surgery becomes unbearable.
“I won’t even take a full one,” she
says. “I feel they are toxic. It wasn’t
just losing my sister, it was everything
I went through with her before she
died. These drugs are evil.”
Opioids have been in use for
thousands of years and are essential