Emma Jarvis: Measures needed to prevent deaths from deadly new drugs making their way into our State

The latest National Wastewater Drug Monitoring Report has found record high consumption of illicit drugs around the country, and while cannabis is still the most widely used illicit drug, Australians use of harder drugs such as heroin and cocaine has soared.

Regional WA had the highest consumption per capita of methamphetamine nationally in December 2023, which is of immense concern to law enforcement agencies and drug treatment providers. As yet, my organisation Palmerston hasn’t seen any appreciable recent increase in demand for its services, and while alcohol is still the primary drug for which clients are seeking treatment, methamphetamine is not too far behind.

The report, which covers about 55 per cent of Australia’s population — about 14.1 million Australians — also showed nationally, there was record high average consumption of methylamphetamine, MDMA, MDA, ketamine, alcohol and tobacco, in both capital cities and regional areas.

Wastewater analysis is a cost-effective, non-intrusive method of measuring drug use at a population level. However, it must be remembered that this is lag data and there are other emerging drugs we need to be aware of which are potentially deadly.

One of these is nitazenes, a synthetic opioid 1000 times more potent than morphine.

Nitazenes were developed about 60 years ago as an alternative to morphine, but because of their strength and high potential for overdose were never released. Globally, and in Australia, nitazenes have appeared in fake pharmaceutical products and as contaminants in drugs such as heroin, methamphetamine, MDMA and ketamine.

Therefore, a broad range of people could be affected by accidentally or intentionally taking Nitazenes. This ranges from people who use drugs occasionally at music festivals, to people who regularly inject drugs.

Some Australians have already been fatally harmed — in late June a Victorian police investigation found a synthetic opioid was detected in the bodies of four people, including a 17-year-old boy, found dead in a Melbourne home.

Whilst there are no formal reports yet of nitazenes being found in WA, clinicians are watching and waiting with caution and concern.

Australia has an opportunity to learn from the North American and European experience of severe harms related to synthetic opioids to prevent and manage potential clusters of both fatal and non-fatal overdose. To do this, a range of measures, which are feasible, effective and consider the interrelating areas of emerging drug use such as policing, health, treatment and existing legislation are essential.

Evidence based interventions include:

Drug checking or pill testing

It’s a service available in Canberra and parts of Queensland and Sydney, but for most of Australia, drug checking before use, is not available.

In WA in January the Cook Government said they have no plans to introduce pill testing in WA but would continue to monitor emerging pill-testing research. In my opinion, drug-checking has a harm minimisation role to play in preventing overdoses.

Research indicates that when drug users have accurate information about what substances they are taking, they will discard drugs which contain harmful substances.

In addition to accurate, professional testing, Australia might must also look to other responses to the synthetic opioid crisis in North America which have been effective. This includes the production and roll out of testing strips, which should be available and free to anyone who is intending on using drugs. These can be distributed by outreach professionals, be collectible at drug treatment services and pharmacies, alongside a campaign to raise awareness and encourage use for people using drugs.

Naloxone

Naloxone is a medicine that reverses the effects of opioids, and is used in hospitals, by paramedics and community members to treat overdose. However, given that people may inadvertently consume nitazenes contained in drugs sold as stimulants, having Naloxone in a wide range of settings, including night clubs, festivals, music events, and people’s homes will be vital to respond quickly. In WA Naloxone is available for free with no prescription and can be found in needle exchange programs and pharmacies.

Meeting treatment demand

Increasing alcohol and other drug treatment services to meet a potential surge in demand might also be considered. The non-government sector continues to advocate to the state and federal governments for system gaps to be met, to ensure we have the capacity to treat those who need help.

While the wastewater reports provide helpful snapshot data into alcohol and other drug use across the country, Palmerston encourages the Federal and State governments to use all available data, to influence alcohol and other drug policy and planning.

And as potent synthetic opioids hit Australian shores, there is an urgent need to plan for a potential sharp increase in overdoses. We need to make sure that if the worst happens here in WA, we’re ready.

Emma Jarvis is the CEO of Palmerston.