September 7, 2017  |  Second reading

Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017

MR HOWARD (Buninyong) — I am pleased to add my comments to the Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017. As we have heard from other speakers, just in 2015, 453 people across this state died from drug overdoses. We know that that is a significantly higher figure than for the number of people who died on our roads, and most people in our community would not be aware of that. Also, when you talk about drug overdoses most people in our community would consider that that was by people who had overdosed as a result of heroin or a similar illicit drug. As we know, that is not the case. In the 2015 figures 358 people died as a result of taking a recognised pharmaceutical, and many of those were given to them on prescription.

We have had the campaign about deaths on roads. We accept that there should be zero deaths on roads, so there has been a lot of attention focused on reducing our road death toll to zero, which is entirely appropriate. But on the other side of things we have not focused as much attention as we should have on dealing with drug overdoses. I am glad that this government is moving forward, listening to the community and doing something to help bring down the number of people who die from drug overdose.

There is one other thing I might add in terms of previous speakers. This is one of the bills that it is good to be in the house for, because people are able to speak passionately about a very important topic. But I noticed that the member for Mornington — and certainly most of the comments made by the member for Mornington were very good — said that most people would know that prescribed drugs are safe, which I think are the words he used, and that the taking of pharmaceuticals in a prescribed manner is safe. But the reality is, and people should recognise, that that is not strictly true. We know that with most pharmaceuticals there will be side effects, and with some pharmaceuticals there are of course very serious side effects. While GPs understand this, they have to prescribe them with a sense of balance.

We know that when pharmaceuticals are prescribed for pain relief and for dealing with depression, generally the clinicians prescribing those do know that they have serious side effects. The main drugs I am talking about here are the opioids and the benzodiazepines. Benzodiazepines are clearly the other area of concern. The reality is that even a good GP will prescribe or can prescribe more than is appropriate for the patient and that often the patient can get addicted to prescribed drugs. That is something that others in our community are not aware of and that fortunately more and more GPs are becoming more aware of. Clearly there needs to be more research in the area of pain relief on using drugs other than these drugs, and that is happening.

I am fortunate in this Parliament to be chair of the Law Reform, Road and Community Safety Committee, whose current inquiry is into drug treatments and the way other governments in other jurisdictions deal with drugs. I have been very interested to learn so much on this topic. Clearly in dealing with the issue of drugs and drugs that lead to dependency there are many issues we need to be aware of. One of the things I learned recently when I went to the USA is that prescription drugs are a significant problem there. We know that in the USA, where they have a sense of free trade, drug companies promote pharmaceuticals to solve all of the problems of life and that there is a very serious overuse problem associated with pharmaceuticals in the United States. Fortunately the problem is not so bad here, but we do need to recognise that there is a potential problem, or there is a serious problem out there, and hence this legislation on real-time monitoring of drug prescriptions by both doctors and pharmacists.

One of the other things I have learned, though, and something that is a threat of this legislation, while it will be helpful, is that the other side of it is that on the issue of addiction to heroin and many drugs — where people go out there to seek illicit drugs — many of those people started on prescription drugs. The sad thing is that if we push people off prescription drugs, we have to be wary that the tendency is that they could be pushed into a worse lifestyle where they have to go to the black market to access drugs and they do not know the quality of those drugs, and that could land them with more problems. So a very important side issue attached to this legislation is that we need to be very careful to ensure that, when doctors do pick up people who have been doctor shopping or seeking more medication than they should appropriately have, they direct them into the appropriate channels to ensure that care is provided. That is vitally important.

Another thing that is vitally important is that this is not just a Victorian thing and that we look to see that this can be a national strategy. I am pleased to see that the federal government is moving on this score. It is important that we have the right IT capacity to be able to do that, and I am pleased to see that in Victoria we are now confident that we have that so that in the rollout of this we will be able to see that all GPs and all pharmacists across Victoria can access the system and that we have the appropriate training for them to ensure this is done.

The other thing that I really want to say in regard to my learnings on the issue of drug addiction and people who have drug problems is that the worst thing we can do is to stigmatise this issue of drug addiction. The worst thing that can happen is that people cannot share advice on what is going on in their life with the people around them. We need to recognise that drug addiction is a health problem. It is not a criminal matter. We need to ensure that we work to destigmatise the area to recognise that people with a health problem should be able to come forward and talk to family members, talk to GPs, talk to clinicians and talk to people who can help them so that they can get the help at the earliest possible time. As well as that, our government — any government — needs to make sure that it is in a position to be able to provide that support.

I am pleased that in Ballarat recently we announced a 20-bed facility for drug rehab, but we know that there are more required. I have also been interested to hear that you do not necessarily need to have long-stay treatment to help people off drugs. We heard from some clinicians this past Monday who advised that even short periods of advice can be very helpful and short efforts of support can help people if they are not ready for residential rehab or if residential rehab is not going to be appropriate for them anyway. There needs to be a range of supports available, and that does not necessarily mean just focusing on the specifics of drug rehab.

People who are addicted to drugs need to have the appropriate social supports to recognise what the underlying issues are and how we can help that person to deal with those broader ranges of issues. In working through the issues that the law reform committee has been working through we realise this is a very complex area. However, one of the things that has been very clear in the advice given to us is that, in dealing with prescription medication for which there is a very significant concern, real-time monitoring is a very good next step, and I am pleased that we are moving on with it.

I also want to say — we have recognised that John and Margaret Millington are here today and have been the driving forces in pushing this issue — that it should not be necessary for people who have lost someone to get out there in the public and share their story. It is sometimes sad and a challenge for them to do so, but it is helpful for people across our community to hear those real-life, human stories. And it is when that happens that it helps to drive politicians to take action, to feel confident that the community might understand these issues better and to recognise they are real people that we want to help.