Silent Killer: The Opioid Addiction Crisis that has Crept Up on Regional Australia
Behind closed doors in a big country town, a young woman cooks up a legal painkiller to produce a potentially lethal high.
“Some people wake up and have breakfast. I wake up and have a shot,” she says.
“That’s my breakfast.”
Fentanyl is a high-strength opioid, prescribed by doctors and sold as slow-release patches to relieve the constant pain of cancer patients.
But used like this, it can kill.
The practice is dubbed “Russian roulette” because users cannot predict how much fentanyl they’re drawing into the syringe.
That means the solution can end up being highly potent and even deadly.
“People overdose all the time,” the woman says.
She knows, because she was one of them.
Medics revived her and now she’s speaking out anonymously to try to help save lives, including her own.
“You never hear of, ‘such and such died of fentanyl’ on the news,” she says.
“But people die from it all the time, and young people die from it.
“Being a drug addict is not a life. You’re just in existence.”
In regional Australia, the tragic effects of the drug ice are well publicised but opioid misuse seems to have crept up on almost everyone.
“It worries me to death,” says Iain Cartney, a pharmacist in the town of Bairnsdale, in Victoria’s east.
He knows that fentanyl and other prescription drugs are being diverted from those it is prescribed to and used dangerously.
“We’ve had eight deaths in the last 12 months in this pharmacy alone,” he explains.
“We have a father who is actually going without his medication because his son is taking them and onselling them.”
Across rural Australia, in towns like Bairnsdale, home to 14,000 people, the opioid black market is thriving.
Trades are made through bedroom windows in the poorer parts of town and one fentanyl patch, worth a few dollars at the local chemist, can fetch $100.
Dealers are making big bucks and users are spiralling further into addiction, in silence.
“You’ve got patients and they’re abused from nine years old; hideous crimes committed with no penalty for the perpetrator and they have to live with these demons every day,” Mr Cartney explains.
“You ask why drugs? That’s why drugs. It’s an escape.”
Fentanyl is 50 times stronger than heroin and misuse is on the rise.
Eight hundred Australians die each year from prescription drug overdoses and the toll is highest in rural areas.
It’s early days but there are fears the country is headed down the same road as the United States, where opioid addiction has become a national emergency.
“One of those indicators is the level of use and prescription of fentanyl,” Shane Neilson, from the Australian Criminal Intelligence Commission explains.
“We are concerned, and we are taking steps to identify the precise level of diversion.”
But Australia is a long way off from the US experience.
“There’s different medical systems in our two countries, different regulations for pharmaceuticals for example,” Mr Neilson says.
“And we don’t have a land border with a country such as Mexico where there’s significant illicit manufacture of fentanyl.”
The Federal Government is working on a national plan for real time prescription monitoring, which would alert doctors and pharmacists when patients are trying to buy certain drugs too often.
It’s underway in some states but there’s a long way to go, and pharmacist Iain Cartney says that approach will only “scratch the surface”.
He’s worried it won’t do anything to stop the diversion of drugs onto the black market and he believes more medical specialists should offer methadone at their clinics and pharmacies.
Methadone is prescribed to people trying to withdraw from addiction to drugs like fentanyl and heroin.
Mr Cartney is the only pharmacist in his town who offers the methadone service.
“I’ve heard comments such as ‘I don’t want that sort of person in my pharmacy, I don’t want other people to be affected, my customers to be affected’.
“So pharmacists are judging and making decisions based on the type of person without even knowing that person. That’s fundamentally wrong as a human being.”
In Bairnsdale, local couple Peter and Margaret Down are trying to help, even though they’ve never been directly affected by drugs.
They first heard about how drugs were tearing families apart in their rural town two years ago, when their daughter encouraged them to attend a meeting about ice.
“Most people like us don’t see it. It’s there but you don’t see it,” Peter Down says.
They’re both about 80, but age hasn’t stopped their determination to act.
Mr Down, a retired builder, has used his skills to design the Hope Centre, which will be run and managed by professionals from Melbourne-based rehabilitation service Odyssey House.
The rehabilitation facility could eventually care for up to 112 people at a time.
They have a planning permit to build and are now on the lookout for funding.
Health experts like Mr Cartney are on board.
“We need to have people at a federal and a local level actually working together to actually create cultural change,” he says.
“Or the crisis is only going to deepen and we’re actually going to find ourselves in an abyss that’s very difficult to get out of.”
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