This week, the Australian Institute of Health and Welfare revealed a shocking statistic: more Australians are misusing pharmaceuticals than any illicit drug, bar cannabis. Of course, we know from our meeting statistics that the “big three” substances linked to harmful addictive behaviour for quite some time have been alcohol, ice (or other amphetamines), and prescription medication, but the numbers detailed in the AIHW report are jaw-dropping in and of themselves.

Just under five per cent of Aussies are misusing pharmaceutical drugs, whether that’s an over-the-counter medication like codeine, or prescription opioids. In fact, opioid analgesics appear to be the medication most highly misused or abused by Australians, with medical-grade painkillers like codeine, oxycodone, and morphine – the sort of stuff you were probably prescribed if you’ve ever been to hospital for surgery, or a broken bone – topping the list. The rate of misuse of pharmaceutical drugs in the general population outstrips cocaine and amphetamine use by a significant margin: almost double for cocaine, and over treble for amphetamines.

As we’ve previously covered, prescription medication, particularly opiates, are often far stronger than other illicit substances within the same family. Fentanyl, for example, can be hundreds of times more potent than heroin. The grim reality of this potency is the death rate: due to opioid overdose, which in Australia far outweighs either heroin or ice. Meanwhile, in the US, drug related deaths are the leading cause of fatality for Americans under 50. However, the profile of pharmaceutical drug abuse is far from the harmful stereotype of a person battling addiction.

This ABC report shines a light on the “mundane” path to addiction faced by many of those in the clutches of opioid addiction. This might seem obvious to anyone who’s ever attended a SMART Recovery Australia meeting, but all paths to addiction are ordinary. There is no one set of circumstances that leads to addiction. We know that trauma, isolation, and mental illness are strong correlating factors in the development of addictive behaviour, but every story is unique, and no story is more or less remarkable than the next. Although the narrative of the nefarious “doctor shopper” – people who go from one dodgy doctor to the next to fuel their addiction – pervades the media, the vast majority of those suffering from opioid addiction are those who were prescribed a medication in the wake of an injury, chronic illness, workplace accident, or surgery. In the last year, over six hundred people died due to opioid overdose. Doctors report the “typical” opioid patient as “at that high-functioning end of the range, people with a background of tertiary education and a job”.

Unfortunately, as is so often the case in battling addiction, government policy and stigma remain the biggest barriers to preventing drug related deaths. The $16 million Real Time Prescription Monitoring System provides medical professionals with an instant record of a patient’s prescription history, targeting those infamous “doctor shoppers”. However, this fails to provide a medical or harm minimisation based response to the overdoses occurring across the country. Increased provision of anti-overdose drugs like Narcan, and widespread education campaigns to inform at-risk individuals of how dangerous opioids can be are required to stem the tide of overdose deaths.

The other major barrier to any kind of meaningful impact is the continuing stigma against drug users. Even the aforementioned ABC report relies on the mythology of a stereotypical drug user:  “street-based using, marginalised individuals”. Many people suffering from addiction and at risk of overdose do not identify with this stereotype, and choose not to seek help on this basis. Education and understanding are key to embracing those who are suffering from their addictions and increasing access to life-saving treatment and rehabilitation.