August 24, 2017

The unintended consequences of cracking down

The unintended consequences of cracking down

Close your eyes and imagine an overdose. What drug do you think was used?

Would it surprise you to learn that the majority of overdose deaths are not due to heroin, but instead pharmaceutical drugs?1

Overdoses associated with opioid painkillers and tranquilizers have become such a problem that it’s fueling discussion of a ‘crackdown’ on prescribing. The crackdown is coming in the form of real-time prescription monitoring – a way that health professionals can perform online checks before providing medicines2 and prevent doctor shopping.

Real-time monitoring is a major focus for preventing harm associated with pharmaceutical drugs. It’s an important strategy. But it’s not the whole story.

We need to think through the possible unintended consequences.

People need support

Consider what might happen when you take a prescription away from someone who is misusing pharmaceutical drugs. Whether a person is in physical pain, emotional pain, or both, taking away the drugs doesn’t take away the pain.

The result could be that people feel alone and abandoned. Some might look for a black market supply of pharmaceutical drugs, or even turn to other drugs like heroin.3

So as access to pharmaceutical drugs is reduced, we need something there to fill the void. And people currently misusing need help to find treatment and support pathways – for their pain as well as their misuse.

We also need to look at the bigger picture here. Why are so many Australians struggling with pharmaceutical drug misuse?

Part of the problem is a culture which often expects that a pill can solve our problems.

Shifting the culture on pharmaceutical drugs

Why and how pharmaceutical drugs are prescribed has a big influence on the way people use them.

But changing prescribing practices isn’t just about handing out fewer pills.

Doctors and patients need to bring a different mindset to pain management, and how they deal with mental health conditions like anxiety. In some situations, painkillers or tranquilizers can be the appropriate treatment – particularly if the pain is acute and short-lived. But too often pills are our go-to, even when we know they won’t work.4

Drugs don’t “fix” the root cause of pain, stress or anxiety. They only ever mask it.

This means we need to find different ways of managing these issues, which means challenging our reliance on pharmaceutical drugs.

Other options for managing pain, stress and anxiety

The good news is that there are alternative approaches to address pain, stress and anxiety that can, in many circumstances, be used alongside short-term painkiller or tranquilizer prescriptions. Approaches like:

  • counselling and cognitive behavioural therapy (CBT);
  • therapy and exercise;
  • diet and lifestyle issues; and
  • practicing mental techniques for relaxation and mindfulness – pictured at right, a woman relaxes in a floatation tank.

The beauty of alternative approaches is that they go beyond just addressing pain or anxiety. Alternative approaches help with managing physical and mental health. The result is that people can cope with stress at work and home. Sleep better. And have more energy for family, friends and other interests.

How to move forward

Many people don’t know that alternatives to pharmaceutical drugs exist.

An important first step is to empower people to discuss all the options with their doctor and encourage them to become an active participant in caring for their health.

There are tools to help people have conversations with their doctor, like the Alcohol and Drug Foundation’s ‘Things to ask your GP’ – a tool for patients to assist in talking with their GP about the pros and cons of medications and non-drug alternatives.

Sharing tools like this with our friends and families is important too.

We do need to address the pharmaceutical drug problem in Australia, but it’s so much more than just reducing supply through crackdowns including real-time monitoring.

The unintended consequences may be more than we bargained for.

Any answer will involve approaching the problem holistically. In doing so, we have the opportunity to go beyond just addressing overdose deaths, and instead help people to find ways of enjoying life, on their terms, and without the need for risky medications.