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It’s famously taken the lives of Prince, Tom Petty and countless others – so just how long until Australia faces its own opioid crisis?

On the morning of December 8, 2019, rapper Juice WRLD – real name Jarad Anthony Higgins – was met with a raid as his private jet landed at Chicago’s Midway International airport, on the suspicion the plane contained weapons and narcotics.

During the search, the “Lucid Dreams” rapper began convulsing and went into cardiac arrest before he was pronounced dead at 3.14am.

The Medical Examiner’s Office would later rule that he “died as a result of oxycodone and codeine toxicity”.

He was just 21 – and just one of the latest casualties of America’s opioid crisis, currently killing an average of 130 people a day. And if Australia’s statistics are anything to go by, we’re hot on the trail to becoming the next in line to be engulfed by the deadly epidemic.

Generation Rx

Once reserved for short-term or severe pain, opioid use has exploded over the past two decades, to the point where the US saw its residents’ average lifespan drop for three consecutive years from 2014. The unsettling statistics came after an upswing in suicide and drug overdoses – of which opioids were the leading culprit.

“The big risk with opioids is that they’re incredibly powerful. [They work] by reducing the excitability of nerves, because they’re able to essentially shut them down,” said Addiction Medicine Specialist at Monash University, Professor Dan Lubman.

“The problem is that when [users] use too much, they also reduce the nerves that drive breathing, which can cause your breathing to stop and that’s when people are overdosing and, unfortunately dying.”

It’s a devastating scenario that’s seen too many lives taken and too many families torn apart. So how on earth did it become this bad?

The answer, according to Professor Lubman, is a complicated mix of doctors who hoped to find the answer to severe pain relief for patients who genuinely needed it, and pharmaceutical companies who allegedly fuelled what would eventually become a horrific epidemic of unprecedented proportions.

“Basically, there was an overprescribing of opioids and that was largely driven by the pharmaceutical industry that claimed what they were selling was not addictive and that nobody should suffer from pain. Now there’s several lawsuits in the US against these companies,” he explained.

Such was legal action was launched against Purdue Pharma, the maker of prescription drug OxyContin, which is currently facing nearly 2,700 lawsuits for allegedly putting “profits over people” and falsely promoting the drug by downplaying the risk of addiction. After the company filed for Chapter 11 bankruptcy in September, a judge granted that the lawsuits against it would be put on hold until at least April.

From Dealer to Doctor: Is Australia Following Suit?

“Opioids claim the lives of three people a day in Australia,” Professor Lubman said.

“Because we’re seeing an oversupply of prescription medications, the increasing prescription drug deaths, and a rise in heroin deaths, it’s all suggesting that we’re seeing an increasing presence of opioids in Australia.”

Paired with this increase, and in what may be a chilling insight of what’s to come, Australia has seen a shift away from illicit drug deaths, like heroin, to overdose deaths that are now being ruled by pharmaceutical opioids, with statistics showing a whopping 60% of opioid-induced deaths in 2018 being attributed to the prescription version of the drug.

And while pharmaceutical drugs are now leading the pack when it comes to overdose deaths, it doesn’t mean we can breathe a bittersweet sigh of relief that heroin – once largely, and ignorantly, affiliated with the rock and grunge stars of yesteryear – has seemingly taken a back seat, because looking at the numbers, that’s simply not the case.

“There were 430 heroin-related deaths in 2018 – which is the highest number since the year 2000,” Professor Lubman explains. “And we’ve seen a significant increase over the past five years.”

“So that, together with the fact that we have 14 million prescriptions for opioid painkillers and with 3.2 million people who live in Australia with chronic pain, we have to be able to learn our lessons from us and make sure we don’t follow what happened in North America.”

“The Nurse Said if I Left I Wouldn’t Make It ‘til Tomorrow”

Former addict Olivia knows this lesson all too well – along with the slippery slope into a life-destroying opioid addiction that can begin with a simple pain pill. After meeting a 32-year-old opioid addict as a teenager, the Sydneysider was offered an oxycontin pill, of which she assumed would be relatively harmless.

“Thinking about it now, I might have been a little more reluctant to try something if it was heroin, rather than a pain pill,” she said, adding, “At first I was just swallowing the crushed up pills and then I asked the guy if I could try it how he was – using needles,” she said.

“I injected the pills and then when I couldn’t get the pills, I moved on to heroin – and when I couldn’t find heroin I would try to get the oxys again.”

Spiralling into a devastating addiction that at one point saw her hospitalised with a kidney infection, pneumonia and her organs on the brink of failure – and later septicaemia – the now-23-year-old said even several near-death experiences weren’t enough to scare her into sobriety.

“It’s like I didn’t even realise I was sick,” she said. In fact she had been so ill after using, that upon yet another hospital admission, doctors told her if she hadn’t called the ambulance she would have been dead in two hours.

“I was still high and paranoid and screaming at the nurses. I remember a nurse coming after me and told me, ‘if you leave you won’t make it to see tomorrow’.”

Realising that she had two choices – to end her spiral, or end up dead – Olivia undertook methadone maintenance treatment and has since been clean. But she is simply one of the lucky ones.

“100 Times Stronger than Morphine”: The Terrifying Truth About Fentanyl

Another terrifying trend emerging across the already opioid-riddled US is the rise in highly lethal, synthetic opioid fentanyl, a drug that is 100 times more potent than morphine, substantially stronger than heroin, and another direct result of the opioid crisis.

“The US essentially created a whole generation of people who are addicted to opioid painkillers, so the response was to reduce the supply of those drugs,” Professor Lubman explained, adding that it caused users who no longer had access to opioid prescription medication to move into the illicit drugs market.

“Then the US saw a massive influx of synthetic fentanyl,” he added.

Among the lives fentanyl has most famously claimed include Prince, Tom Petty, Lil Peep, Mac Miller, and most recently, rising rapper Lexii Alijai. They were all accidental overdoses, with the majority likely having no idea they had ingested the deadly substance.

A 2mg dose of fentanyl (pictured alongside a US penny for comparison) is enough to prove lethal for any who ingest it. Photo: U.S. Drug Enforcement Administration

Professor Louisa Degenhardt, Deputy Director of The National Drug and Alcohol Research Centre (NDARC) explained that the danger of the extremely potent drug – which currently exists in patch form in Australia – lies in the minuscule amounts it takes to overdose.

“Fentanyl is a respiratory depressant, and because it is so concentrated, people can misjudge the dose for themselves to a dangerous degree,” she explained, adding that while illicit fentanyl has yet to appear in Australia, there have been deaths attributed to those misusing the transdermal fentanyl patch, which have “almost all been among people injecting fentanyl extracted from prescribed fentanyl patches”.

If we have any chance of getting people to avoid people relying on such potent opioids for pain relief, a wider variety of treatment plans need to be undertaken, along with a de-stigmatisation of drug users, as many users will often avoid seeking help to avoid judgement from health professionals.

“Because of the broader stigma and discrimination around people who use drugs, there’s a lack of services and doctors who are willing to offer treatment for opiate addiction,” concludes Professor Lubman.

“But if we truly want to stop this epidemic we need good quality, easily accessible treatment for people who have developed addiction to opioids.”

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