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AMA calls for tighter control on prescription -

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AMA calls for tighter control on prescription drug use

The World Today - Monday, 27 October , 2008 12:28:00

Reporter: Michael Edwards

ELEANOR HALL: The Australian Medical Association is calling for a tightening of controls on
prescription painkillers to prevent them falling into the hands of drug dealers.

New Medicare figures reveal that taxpayers are funding a rise in the unauthorised use of
morphine-style prescription drugs.

The figures coincide with a spike in the abuse of these drugs across Australian cities as Michael
Edwards reports.

MICHAEL EDWARDS: Painkillers such as Oxycodone and MS Contin are prescribed by doctors to patients
suffering from chronic pain.

They're restricted substances and their use is monitored by both state and federal health agencies.

Gideon Warhaft is from the New South Wales Users and AIDS Association.

He says prescription painkiller abuse is widespread and while it's still dangerous, it is safer
than using street-level heroin.

GIDEON WARHAFT: It's another substitute for heroin use and I think that a lot of users find it more
reliable than street-based heroin because they know what they are getting. So they are able to have
some consistency with the dose they take. It is one of the things that makes it attractive to some
users.

MICHAEL EDWARDS: Medicare figures show in 2007/2008 more than $53-million was spent on the drugs.
Doctors say part of these prescriptions are being obtained illegally entering the black-market
through the practice of doctor shopping - which involves users roving from surgery to surgery
conning doctors into believing them that they need the drugs for medicinal purposes.

The Australian Medical Association says there needs to greater co-operation between health
authorities to prevent this happening.

Dr John Gulotta is the chairman of the AMA's Therapeutic Goods Committee.

JOHN GULOTTA: There are safeguards in place and there are state regulations as well that ensure
that doctors have to prescribe within guidelines and to the appropriate patient for these
narcotics. But it important for people who are actually on these to be on them for the shortest
amount of time and ensure that they are stored safely at home and ensure they don't actually get in
the wrong hands.

MICHAEL EDWARDS: But doctor shopping does take place and fraud does take place. What could be done
to stop this?

JOHN GULOTTA: I mean obviously doctor shopping does occur. There is a doctor shopping hotline but
in certain cases it doesn't work because unfortunately the way that the systems are, there isn't a
linkage of computers between doctors and pharmacists. So if we sort of had an on-line, real time
prescribing and dispensing sort of network, that would actually help prevent leakage.

MICHAEL EDWARDS: But Gideon Warhaft from says the only way to stop people abusing drugs is for
governments across Australia to provide more places within treatment programs.

GIDEON WARHAFT: I think that there is a short of treatment programs ranging from pharmacotherapy
programs such as methadone, such as Suboxone ranging right through to detox and rehabilitation. The
whole gamut is required to allow people to have a chance of actually changing their lifestyle and
changing their drug intake.

MICHAEL EDWARDS: So is there the possibility that people, when heroin is not available and if they
can't get treatment for their addiction, they just have to switch to other substitutes such as
Oxycontin.

GIDEON WARHAFT: I think that is one of, I think that is right. I think that where there is no
choice, when people have fewer options, they tend to find it harder to change their behaviour. So I
think that the more options that we give to drug users, the bigger chance we have of actually
having people stop taking things for example like Oxycontin and perhaps taking up other
pharmacotherapies or other treatment options.

MICHAEL EDWARDS: Dr Andrew Byrne runs a drug treatment clinic in inner-city Sydney.

Dr Byrne says he's seen a sharp rise in the abuse of prescription drugs over the past few years.

He says the only way to stem the abuse of any type of drugs is treatment.

ANDREW BYRNE: The biggest factor is that people who are addicted to opiate drugs have only very
limited access to treatment.

In New South Wales we have dozens of addiction treatment clinics, private and public. We have GPs.
We have hospitals which provide services however many of these services have complete log jam and
simply don't take any new patients.

Some have long waiting lists but most have stopped even keeping waiting lists.

ELEANOR HALL: That is addiction specialist Dr Andrew Byrne ending Michael Edwards' report.