The Central West has recorded 115 drug-induced deaths in a four-year period.
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For the Western NSW primary health network, the rate of drug induced deaths were 11 out of 100,000 people, including a rate of 9.1 for unintentional drug-induced deaths and 1.5 for drug-induced suicides in the 2017 to 2021 period.
Of the 39 people from the primary health network whose deaths were drug-induced in 2017, 33 were unintentional.
Similarly, 29 of the 34 who died in 2018; 29 of the 36 who died in 2019; 23 of the 30 in 2020; 27 of the 30 in 2021 were also unintentional.
The COVID pandemic affected part of this period and, according to the report, border closures, lockdowns and increased police powers had substantial impacts on some drug markets, particularly those involving cocaine, methamphetamine, MDMA and heroin. Wastewater analysis also showed decreased consumption.
However, the same restrictions placed extra psychological stress on people and prescriptions for psychotropic drugs such as anti-depressants, anti-psychotics and psychostimulants increased significantly.
Alcohol sales also increased significantly between 2019 and 2021.
The report said, research showed the same restrictions changed the way people used drugs and those who regularly use drugs were stockpiling them due to concerns about availability.
It was suggested those changes in behaviour could had increased the risk of overdose, as did changes to harm reduction and drug treatment sectors where services couldn't provide face-to-face contact or take on new clients.
According to the report, the number of unintentional drug-induced deaths has surpassed the road toll since 2014, with the gap continuing to widen.
When it came to unintentional overdose deaths, the drugs involved were opioids, benzodiazepines, stimulants, antidepressants, alcohol, anticonvulsants, neuropathic pain modulators, antipsychotics and synthetic cannabinoids.
Penington Institute CEO John Ryan said a fatal overdose occurs every four hours across Australia with First Nations people more than triple the non-Indigenous population when it came to unintentional overdoses.
"Unintentional overdose death has far outpaced our population growth over the past two decades," Mr Ryan said in the Annual Overdose Report 2023.
"Patterns continue to evolve: stimulants and benzodiazepines are increasingly involved in fatal overdose. Of particular concern, overdose deaths in Australia that involve dangerous synthetic opioids like fentanyl have been increasing."
A NSW Health spokesperson said there are a range of programs in place to reduce harm done by alcohol and other drugs.
Among the harm reduction programs is monitoring prescription and the supply of high-risk pharmaceuticals through SafeScript NSW to reduce inappropriate prescribing and misuse.
They said the Opioid Treatment Program provides therapies and services to improve the quality of life and wellbeing for people with opioid dependence.
"The program is delivered across the public, private, correctional, and primary healthcare, and community pharmacy settings, including in general practice and community pharmacies," the spokesperson said.
The Take Home Naloxone Program introduced in 2019, gained particular approval from the Penington Institute.
The program is run through public alcohol and other drugs services, needle syringe programs, Justice Health, and in the Medically Supervised Injecting Centre.
"Naloxone is an easy to use, life-saving medicine that can temporarily reverse an opioid overdose," the spokesperson said.
"People at risk of experiencing an opioid overdose or who may witness an overdose can get naloxone for free without a prescription from some NSW community pharmacies, NSW Health needle and syringe programs, opioid treatment services and NUAA."
All NSW local health districts, specialty health networks and correctional facilities now also provide access to a new long-acting, injected formulation of buprenorphine known as depot buprenorphine.
It is administered weekly or monthly and can be more convenient for patients, reduce treatment costs and improve medication adherence. It has less risk of diversion and non-medical use, enhancing community safety.
In regional NSW, pharmaceutical opioids were the greatest cause of unintentional drug-induced deaths in the early 2000s.
However, by 2012 benzodiazepines began to kill more people and stimulants were also killing more people than previously.
The risk caused by the drug was enough to prompt magistrate David Day to warn a user in Orange Local Court on Thursday, August 31.
"You can kill yourself with that [type] of prescription drug," Mr Day said.
"Benzodiazepines are safer than barbiturates but you can still kill yourself."
By 2021, the leading cause of unintentional drug induced deaths were other pharmaceuticals followed by stimulants, benzodiazepines, pharmaceutical opioids and heroin.
Rural and regional areas had a higher-rate of unintentional drug-induced deaths than metro areas with rates of 6.6 and 6.2 per 100,000 people respectively in 2021.
The leading cause of those regional deaths were opioids (765), benzodiazepines (544), stimulants (461), antidepressants (324), alcohol (315), anti-convulsants (206), anti-psychotics (187), cannabinoids (165) and cocaine (87).
For people aged between 20-29 and between 40-49 drug-induced deaths were the third leading cause of death in 2021 and it was the second leading cause of death for those aged between 30 and 39, behind suicide.
The unintentional drug-induced deaths include drug overdoses, incorrect drugs given or taken in error, and accidental poisoning due to drugs.
Drug-induced deaths that were deemed homicide, suicide or of undetermined intent were not included in the figures. It also doesn't include those deaths where drugs were a contributory factor, such as a car crash.
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