THE number of Victorians dying from drug overdoses or suicide will rise if more doctors are not recruited to treat heroin addicts and tackle a crisis in the state's methadone prescribing service, drug experts warn.
An audit of the system found the number of people receiving methadone and buprenorphine has risen by 15 per cent to more than 13,000 in the past four years. In the period, the number of GPs prescribing the opiate-based heroin replacement drugs fell by the same percentage, to only 400, or about one in 10 GPs.
People in rural areas face the biggest challenge, as an estimated 20 doctors, mostly in inner Melbourne, look after 80 per cent of pharmacotherapy patients.
The Victorian Auditor-General's report, released this month, has renewed fears that patients trying to kick heroin will find it difficult to get help.
David Nolte, a pharmacist who dispenses methadone to about 100 people at his Carlton North pharmacy, said the shortage of doctors and pharmacists willing to treat drug-dependent patients was ''outrageous''.
''If people can't get to see a pharmacotherapy or a drug and alcohol doctor there is a time where they're hot to trot and they want to start on a program. If you miss that opportunity you lose it altogether and people can go back to drug-using, they can overdose or commit suicide,'' he said.
Doctors are more reluctant to take on patients with drug problems, with the Auditor-General's report showing that last year only 24 GPs carried out the training required to prescribe methadone. The state government's target was 70.
Associate Professor Paul Dietze, head of the Burnet Institute's alcohol and other drug research group, said a properly funded and managed pharmacotherapy system was cost-effective.
''It really does save the community a lot of money and a lot of heartache,'' he said. ''It fundamentally alters the way in which illicit drug markets operate and because there's going to be much less demand for drugs, there's much less crime associated with drug use.''
State government reviews of the pharmacotherapy system in 1993, 2003 and last year all recommended an overhaul of services, but the Auditor-General found little progress had been made.
Professor Dietze said the system had been heading towards crisis for several years.
''The prescribers are getting older and some of them are nearing retirement age and they're burdened with what seems to be an extraordinarily large number of clients, so we need to be responding effectively now,'' he said.
Damon Brogan, executive officer of Harm Reduction Victoria, a group supporting illicit drug users, said the worst shortages were in regional and urban growth areas, where one GP could look after up to 500 drug-dependent patients.
''If these patients aren't able to have their prescriptions and their dispensing maintained, they're going to get very, very sick. They might go back to heroin or mix other drugs with alcohol, so there would be the increased potential for both suicide and poly-drug overdose,'' Mr Brogan said.
Harry Hemley, president of the Victorian branch of the Australian Medical Association, a GP in Northcote, believed many doctors were reluctant to prescribe methadone because drug-dependent patients could be disruptive and aggressive.
Professor Dietze called for New South Wales-style public clinics where patients could access methadone for up to a year. Once stabilised, they are seen by GPs privately.
A spokeswoman for Mary Wooldridge, the minister responsible for drug and alcohol policy, said the Coalition's drug strategy would improve access to pharmacotherapy but gave no detail on how this would be achieved.
Jill Stark @'The Age'
An audit of the system found the number of people receiving methadone and buprenorphine has risen by 15 per cent to more than 13,000 in the past four years. In the period, the number of GPs prescribing the opiate-based heroin replacement drugs fell by the same percentage, to only 400, or about one in 10 GPs.
People in rural areas face the biggest challenge, as an estimated 20 doctors, mostly in inner Melbourne, look after 80 per cent of pharmacotherapy patients.
The Victorian Auditor-General's report, released this month, has renewed fears that patients trying to kick heroin will find it difficult to get help.
David Nolte, a pharmacist who dispenses methadone to about 100 people at his Carlton North pharmacy, said the shortage of doctors and pharmacists willing to treat drug-dependent patients was ''outrageous''.
''If people can't get to see a pharmacotherapy or a drug and alcohol doctor there is a time where they're hot to trot and they want to start on a program. If you miss that opportunity you lose it altogether and people can go back to drug-using, they can overdose or commit suicide,'' he said.
Doctors are more reluctant to take on patients with drug problems, with the Auditor-General's report showing that last year only 24 GPs carried out the training required to prescribe methadone. The state government's target was 70.
Associate Professor Paul Dietze, head of the Burnet Institute's alcohol and other drug research group, said a properly funded and managed pharmacotherapy system was cost-effective.
''It really does save the community a lot of money and a lot of heartache,'' he said. ''It fundamentally alters the way in which illicit drug markets operate and because there's going to be much less demand for drugs, there's much less crime associated with drug use.''
State government reviews of the pharmacotherapy system in 1993, 2003 and last year all recommended an overhaul of services, but the Auditor-General found little progress had been made.
Professor Dietze said the system had been heading towards crisis for several years.
''The prescribers are getting older and some of them are nearing retirement age and they're burdened with what seems to be an extraordinarily large number of clients, so we need to be responding effectively now,'' he said.
Damon Brogan, executive officer of Harm Reduction Victoria, a group supporting illicit drug users, said the worst shortages were in regional and urban growth areas, where one GP could look after up to 500 drug-dependent patients.
''If these patients aren't able to have their prescriptions and their dispensing maintained, they're going to get very, very sick. They might go back to heroin or mix other drugs with alcohol, so there would be the increased potential for both suicide and poly-drug overdose,'' Mr Brogan said.
Harry Hemley, president of the Victorian branch of the Australian Medical Association, a GP in Northcote, believed many doctors were reluctant to prescribe methadone because drug-dependent patients could be disruptive and aggressive.
Professor Dietze called for New South Wales-style public clinics where patients could access methadone for up to a year. Once stabilised, they are seen by GPs privately.
A spokeswoman for Mary Wooldridge, the minister responsible for drug and alcohol policy, said the Coalition's drug strategy would improve access to pharmacotherapy but gave no detail on how this would be achieved.
Jill Stark @'The Age'
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