As Victoria logs a record number of overdose deaths, the peak body for alcohol and drugs agencies is urging NSW not let reform fall by the wayside.
In an unusual move, a new report from a peak body representing 87 alcohol and drug services in NSW is urging the state government to get moving on a 10-year alcohol and other drug strategy without stopping for extensive consultation.
According to the Network of Alcohol and Other Drugs Agencies (NADA), the “sector has [already] provided significant feedback on what needs to be included” in a 10-year plan, although it would endorse non-government organisation representation on any steering committee.
The report itself is a response to the NSW government report on its 2024 drug summit. The government’s official response is expected later this year.
More specifically, NADA supports increased investment in telehealth services to reach rural and regional areas, as well as standardising residential rehabilitation funding models to consistently include specialist mental health roles and added support for community-based outreach treatment options.
While the NADA report does not specifically mention general practice, the original NSW summit report does recommend expanding access to opioid substitution treatment to improve integration with primary care and increase the number of GPs prescribing opioid substitution medicine.
NADA’s call came as new data the Coroner’s Court of Victoria revealed that 2024 was the deadliest year on record for overdose deaths in the state.
Last year, overdose deaths in the state rose to 584, surpassing the 2022 high of 552.
Seven in 10 overdose deaths involved a pharmaceutical drug as a contributing factor, while two in three overdose deaths included illegal drugs as a contributing factor. Alcohol was a contributing factor in about one quarter of overdose deaths.
Most overdose deaths involved multiple drugs, with pharmaceutical benzodiazepines appearing the most frequently (52% of deaths), followed by pharmaceutical opioids (36% of deaths) and antidepressants (33% of deaths).
While the absolute number of deaths increased, 2024 represented a slight decline in the frequency of both benzodiazepines and opioids in those deaths, a trend the Coroner’s Court said GPs had played a part in.
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“The continuing decline in the proportion of overdose deaths involving pharmaceutical opioids and benzodiazepines is a very positive development,” the Coroner’s Court report read.
“While it is not possible to attribute the decline to any specific initiative, the work of the Royal Australian College of General Practitioners (which has made a concerted effort over an extended period to support clinicians’ opioid and benzodiazepine prescribing practices, including through the development of comprehensive guidelines for prescribing drugs of dependence), and the Victorian Department of Health (which through its SafeScript system assists clinicians to understand and monitor benzodiazepine and opioid prescribing to patients) must be acknowledged.”
While the proportion of pharmaceutical drugs involved in overdoses has shrunk, the proportion of illegal drugs has increased.
Of the illegal drugs, heroin was the most commonly implicated individual drug for 2024, involved in 248 deaths. Methamphetamines were involved in the second-most, at 215.
The Coroner’s Court flagged that this may be a substitution effect.
“Additionally, the fact that Victoria’s overdose death rate has remained relatively steady while the gap between illegal and pharmaceutical drug involvement in Victorian overdose deaths has closed, suggests that there may be an interaction between illegal and pharmaceutical drug involvement in the deaths,” the report said.
“More specifically, it raises the possibility that people may be substituting illegal drugs for pharmaceutical drugs, potentially driven in part by the above-mentioned initiatives making pharmaceutical drugs more difficult to access.”
The report emphasised that this was just a hypothesis at present.
Men have consistently made up around two thirds of overdose deaths, accounting for around 400 deaths in 2024. Three quarters of overdose deaths happened in metropolitan Melbourne.
