A New Dawn

JENNY BEACH is on the road as soon as the sun peeps over the horizon most days – stray wildlife an ever-present danger during the pre-dawn light. It’s a four-hour drive to Cobar for Ms Beach, who is the manager of a new Alcohol and other Drugs (AoD) program, which was launched by the South Eastern Section of the Royal Flying Doctor Service (RFDS SE) six months ago.

Unlike most of its other fly-in services, the AoD program in central western NSW is being delivered by road. This allows her teams flexibility, essential in an area of health where situations can develop quickly and unexpectedly.

“With almost 90 years’ experience facilitating emergency and clinic services, I think we’ve built up a good sense of the health needs in the regional, rural and remote communities we serve,” Ms Beach said.

The anecdotal experiences of healthcare workers was recently confirmed by the RFDS SE’s report, The Health Care Access, Mental Health, and Preventative Health; Health Priority Survey Findings for People in the Bush.

Released in August, the survey indicated that GP and medical specialist access, and mental health and drug and alcohol services were key health priorities for people living in the bush.

As a result, the service decided to make a significant health investment in Western NSW. It effectively tripled the RFDS SE’s mental health team from five to 15 and established new clinics in Cobar and Dubbo to supplement an existing one in Broken Hill. The team serves clients within a two-hour drive of each hub – or flight in the case of Broken Hill.

The program was able to proceed thanks to an 18-month grant from the Western NSW Department of Health’s Primary Health Network and a partnership with Lyndon, an independent organisation with 30 years’ experience in the field.

Given the alarming results of recent studies on drug and alcohol use, it hasn’t come a moment too soon. A 2013 national survey showed that just over 40% of Australians either smoke daily, drink alcohol in ways that puts them at risk, or had used an illicit drug in the previous 12 months.

Jenny meets her team in Cobar to discuss schedules, casework and programs. Like all regional towns, it has its challenges and like many “front-line” workers in the field, Jenny’s team have identified a new and insidious danger to health and mental wellbeing.

Recent data shows prescription drugs now kill more people than illicit drugs like “ice” or heroin. In Australia, commonly prescribed substances such as oxycontin, fentanyl, codeine and morphine are responsible for some 800 fatal overdoses each year. An estimated 80 per cent of those currently addicted to opioids began their addiction with prescription medications.

This new threat is destroying old stereotypes. Surprisingly, older male Australians, particularly those in regional Australia, are now more likely to die of an overdose than young people in urban areas. In 2014, people aged 30-59 accounted for 78 per cent of all overdose deaths and between 2008 and 2014, there was an 83 per cent increase in per capita deaths in rural and regional Australia. Accidental overdoses also rose 61 per cent during the decade 2004-14.

“This has happened because accessing alternatives like psychologists, physiotherapists and qualified massage therapists isn’t easy or cheap, particularly in rural and remote areas, and prescribing medication seems like an easy solution,” Ms Beach said.

“This led to prescription drugs being targeted by resourceful users and dealers because they are legal and that means they can fly below the radar.

“In the United States, heroin is now cheaper than prescription pills, which are much stronger yet more readily available. Opioid addiction is killing almost 150 people per day and we don’t want to see that happening here,” she added.

In addition to their case work, the RFDS SE team hold events like the one they did in Cobar for World International Overdose Awareness Day, public information sessions and attend local agricultural shows to educate and raise awareness of the mental and physical damage drugs can do.

While community engagement can play a crucial role in saving lives, Jenny believes the roll-out of a national system of real-time monitoring can’t come soon enough. This will alert pharmacists and doctors if a patient is receiving multiple supplies of dangerous prescription-only medicines.

“We welcome the $16m that the Commonwealth recently committed to this initiative, which will help curb supply and prevent the abuse of the PBS system,” Ms Beach said.

“However, cultural change is also needed. We need to make alternatives to pain management through prescription drugs more easily available and encourage people down this road.

“Some days I do feel that we’re fighting a rising tide, but it’s a battle we’re determined to win. However, we need the community, health practitioners, pharmacists and government agencies to all work together.”

As the sun starts to wane, Ms Beach is back in the car. It’s three hours to Dubbo where team members will have similar tales to tell.