Australia is facing an opioid crisis of its own as drug companies push painkillers across the world.
Carmall Casey stands for a portrait in her yard in Black River, Tasmania, Australia, Wednesday, July 24, 2019. From her home in rural northwest Tasmania, not far from the poppy fields that produce half the world's supply of the raw ingredients in pharmaceutical opiates, Casey seethes over a system she says pushed her and so many others into addiction. It is a system that has made opioids the cheap and easy alternative for so many Australians.
Half a world away, Australia has failed to heed the lessons of the United States, and is now facing skyrocketing rates of opioid prescriptions and related deaths. Drug companies facing scrutiny for their aggressive marketing of opioids in America have turned their focus abroad, working around marketing regulations to push the painkillers in other countries. And as with the U.S., Australia’s government has also been slow to respond to years of warnings from worried health experts.
“It’s depressing at times to see how we, as practitioners, literally messed up our communities,” he says. “It’s our signature on the scripts. ... But the pressure being put on by the drug companies, by certain health sectors — that’s the situation that we are facing now.” Dr. Jennifer Stevens, a pain specialist, saw the surge with startling clarity while working at St. Vincent’s Hospital in Sydney.
More than 3 million Australians - an eighth of the country’s population - are getting at least one opioid prescription a year, according to the latest data. “We’re living in a country that is oblivious to what’s going on,” she says. “Why aren’t we learning from America’s mistakes? Why don’t we learn?”When Rustie Lassam thinks of the drug companies that pumped opioids into Australia’s market, she thinks of her infant son’s agonized wails as he went through withdrawal.
In Australia, pharmaceutical companies by law cannot directly advertise to consumers, but are free to market the drugs to medical professionals. And they have done so, aggressively and effectively, by sponsoring swanky conferences, running doctors’ training seminars, funding research papers, giving money to pain advocacy groups and meeting with doctors to push the drugs for chronic pain.
Holliday filed a complaint with Medicines Australia, the pharmaceutical industry’s regulator. But membership to Medicines Australia is not mandatory, and Mundipharma declined to participate in the complaints process because it had dropped out as a member. The campaign, which encouraged people suffering painkiller-induced constipation to talk to their doctors, never mentions Targin by name, because it legally can’t. But the advertising agency Mundipharma hired described on its website how they worked around that regulation, by using print, radio and online ads to target regions where pain medication use was high.
Stevens, the Sydney pain specialist, has pushed back against several drug companies over their marketing tactics. A couple years ago, she says, Mundipharma was marketing Targin to surgeons at her hospital, reassuring them that they could prescribe higher doses. Unlike pain specialists, surgeons are generally not well-educated on the intricacies of opioids, she says.
“We acknowledge that there is an issue associated with opioid misuse,” the company wrote. “However to describe the Australian situation as a ‘crisis’ is alarmist and risks stigmatizing patients who have a legitimate need for opioid analgesics to manage their pain.”David Tonkin blames his son’s death on a system that allowed him to see 24 doctors and get 23 different medications from 16 pharmacies — all in the space of six months.
A few weeks later, Matthew had his first oxycodone overdose. A few months after that, he was discharged from the army.
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