'Hillbilly heroin’ taking hold of our communities
REGIONAL drug routes carved out by ice dealers could enable Queensland's next drug epidemic, experts fear.
Despite the drug ice now being "cheaper than alcohol", trend data shows users are moving to opioids - a narcotic that has shattered communities across the United States, where it's known as "hillbilly heroin''.
In the latest round of national wastewater drug testing one regional Queensland community was found to have the highest levels of fentanyl in the country.
Fentanyl is an opioid 100 times stronger than morphine and the drug involved in the fatal accidental overdose of music icon Prince in 2016.
Queensland Network of Alcohol and Other Drug Agencies (QNADA) chief executive Rebecca Lang said Queensland was not yet in the grip of an opioid crisis, but there were troubling signs on the horizon.
"With the availability of prescription opioids we've seen quite significant increases in prescribing for a number of years now - not with any kind of level of problems that they're seeing in the United States but certainly still enough to be a cause for concern," she said.
Ms Lang said ice, or crystal methamphetamine, users were learning it was a "really fast way to ruin your life" and a growing number were quitting,
"But they're not stopping altogether. There's concern in the sector at the moment that opioid use is what they are switching to," she said.
One lasting effect of ice that could have consequences for opioid abuse, is the incursions it made into country Queensland.
Ms Lang said that 20 years' ago regional areas largely avoided significant drug problems. However, when ice appeared on the scene drug traffickers were able to spread it through country towns.
There are fear those trafficking routes may be here to stay.
"So the real concern we have is that now that those supply pathways have opened up into regional communities that other drugs will follow," she said.
Ms Lang said opioid problems would expose communities to different problems than those caused by ice which can induce psychosis.
"The risk with opioids is less about public disarray and violence, it's more likely that the risk becomes overdose," she said.
"So the risk becomes the community is traumatised by discovering people in varying stages of overdose."
Ms Lang said it was important communities had access to "opioid-overdose reversal" drug Naloxone which is now available over the counter.
The Australian Criminal Intelligence Commission said illegal opioids were often supplied by criminal entrepreneurs or "motivated individuals", including long term addicts.
Some doctors and pharmacists are also complicit in the supply of pharmaceutical opioids to the illicit market. Organised crime also plays a role, manufacture opioids illegally and supplying them to the black market.
In the United States, currently in the grip of an opioid crisis that costs $78.5 billion a year, more than 130 people die everyday as a result of overdose.
The scale of the US problem has seen more than 1700 lawsuits launched against pharmaceutical companies, often by state and local governments, for their role in the opioid crisis.
Authorities in Australia are also starting to move on the problem. The Therapeutic Goods Administration, which regulates health products, fears Australia is "trending down a similar path" to the US. In the 10 years to 2016, the number of opioid deaths nearly doubled - from 591 to 1119 - across the country. In Queensland deaths from accidental drug overdoses have more than doubled in a decade with opioids most often to blame.
The TGA is reviewing label warnings, pack sizes and pushing doctors to use alternatives.
It has already banned low-dose codeine without a prescription
The Queensland Nurses and Midwives' Union said it supported the TGA exploring options to tackle "the use and misuse of opiates in Australia."
"Balanced control measures such as real-time prescription monitoring and enhancing the range of medication pack sizes are such measures that can reduce the 'wounds' and harms associated with opioid use," it told the TGA.
A Queensland Health clinical expert suggested to the TGA that higher dose opioid products be restricted to cancer pain, palliative care, oncology or specialist pain clinics.
Despite the emergence of opioid abuse in Queensland, ice remains more prevalent and its price has dropped in recent years.
"A point of methamphetamine, which would be enough to last a single person … would be somewhere between $50 and $70," Ms Lang said.
"So when you think about that as a night out, it is cheaper than a night out on alcohol. The flip side of that, is that often people who are using methamphetamine are also using alcohol."
People seeking help can call the toll-free 24/7 Alcohol and Drug Information Service for support, information, advice, crisis counselling and referral to services in Qld on 1800 177 833.