Written on the 17 October 2017

Second reading

Tuesday, 17 October 2017

GEORGIE CROZIER (Southern Metropolitan)


I am very pleased to be able to make a contribution this evening to the Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017. I do so and I was just talking to Mr Davis about this actually because it was in fact the former coalition government that, under his guidance and management in overseeing the very important health portfolio, undertook a business case, provided millions of dollars in funding to get this system up and running, and took it obviously to the 2014 election. Unfortunately the Labor government did not match that policy. In fact Victoria is not the first state to do it. Tasmania has done it, to my understanding, and the government is continuing on with that very good work that was commenced under the former coalition government.

I am very pleased that that is the case because, as others have said and others have described in their contributions to the debate, too many people are accessing very dangerous drugs on a formal basis and on an occasional or irregular basis, and sadly they are contributing to their own demise and causing a whole range of different health issues as well. It is my understanding from others who have contributed to this debate that there are quite literally hundreds of people who accidentally overdose because of the access they have in being able to get these drugs.

What the bill does, as it states, is that real-time prescription monitoring will require doctors and pharmacists to view patient records of access to high-risk, addictive medicines before prescribing or dispensing. This information will help doctors and pharmacists make better informed, safer clinical decisions for patients and may provide opportunities for counselling and intervention where necessary. The bill does a number of things, including providing a statutory basis to create a database to monitor prescriptions and mandating the use of the database via prescribers and dispensers. That way you can really have that control of those Victorians who have got an addiction, are requiring assistance and are getting that intervention as required.

Sadly in Victoria at the present time we do not have enough drug rehab centres. There are waiting lists, and that is having a real impact on a lot of social problems and other health-related issues for many individuals. Of course when you look at what we have got in the streets, we have got an increase in homelessness especially around the CBD, with people who might have mental health but also substance abuse issues, and we see the sad indications of what occurs in relation to those people that do not have the proper intervention or the ability to access any of those rehab centres.

In my portfolio areas that I have responsibility for not only homelessness under housing, but also youth justice many young people cannot get the proper access that they require. They are in a life of crime, and often that is contributing to a lot of the crime that they are undertaking, and these crimes are serious. We have seen that. We have seen the state have the crime wave that has occurred very serious, brazen crimes and often some of these people are highly charged on various substances, whether it be ice or other drugs. Of course that is leading to what we have seen in this out-of-control crime wave, but if you are looking at what we are talking about here too, it is those other pharmacological agents or medications that are provided, and people are often shopping around to get what they need, whether it is an oxycodone-based medication or some sort of other pharmacological derivative that is relevant here.

The bill requires a prescriber or dispenser of high-risk drugs to review a patient's previous use of high-risk drugs. In other words, as I have just described, if it is an oxycodone or morphine-based type of medication and somebody has got some other drug use, then this is how that assessment can be made. I think that is a very good thing, because a cocktail of drugs can have that lethal component and cause a drug overdose.

The bill requires prescribers and dispensers to update records of a patient's access to high-risk drugs on a database and allows for exemptions from a requirement to review a patient's previous use of high-risk drugs for example, if they were an inpatient in a hospital or a residential aged-care facility, in palliative care or a prisoner who had shopped around for those prescription drugs. Therefore this would make it less difficult and more unlikely that that scenario would occur, and again I think that is a very good provision of the bill, such that we are trying to protect those people from accessing this lethal combination of drugs and being able to either use them themselves or again of course also onsell those drugs to others who might be drug affected or have a drug addiction.

The bill also creates penalties for misuse of the database or failure to properly maintain the database. Arrangements for schedule 8 treatment permits will be reviewed and streamlined, and there will be a removal of some other administrative burdens. Again, this is going to make a far more effective process.

I mentioned the high-risk drugs like codeine-based types of drugs, but the high-risk drugs include all the schedule 8 and schedule 4 drugs, which include benzodiazepines. For those that do not know, they have a very high tendency for addiction that is, to be easily addicted to. We know that codeine is found in various over-the-counter medications in many instances, and I for one know not that you need be a regular user of it that it is a very common drug to be able to access and is highly addictive. So that is another provision of the bill. Regulations will list which medicines in addition to the schedule 8 medicines should be considered to be monitored poisons and will be included in the scheme also. That database I spoke about earlier is intended to give dispensers and prescribers the ability to avoid inappropriate or multiple prescribing events.

The scheme has got support from a number of stakeholders. There has been wide consultation, to my understanding, and that includes those stakeholders that would be using these types of drugs on a regular basis. Of course that includes doctors and others physicians, surgeons, psychiatrists, pharmacists that are involved in the dispensing or prescribing of these drugs.

There is a wide stakeholder engagement that is supportive of the scheme. I must say that when I was doing a little bit of background on it I looked at the national scheme that the Turnbull government spoke about undertaking and I think they commenced earlier this year and I was pleased to see that the federal government had committed $60 million to a national rollout of a real-time monitoring system that will be in addition to what is happening here in Victoria and will give additional support to those that are involved. I was alarmed to learn that across Australia I think there are around 600 deaths a year of those who have accidentally overdosed on strong prescription drugs such as morphine, OxyContin or fentanyl. That was highlighted by the federal health minister when he was speaking about the national scheme that they are undertaking.

There seems to be a wide and broad degree of support for this, which is a good thing. I, for one, having seen people who have been sadly addicted to these sorts of drugs and seen how their addictions can have some terrible health and mental health consequences, think this is a very good thing. It will give those doctors and also the pharmacists the guidelines that they require.

But I would also say, and I take on the point made by Ms Kealy in the other place, that there are not enough drug and rehabilitation beds.

The government has ignored this fact.

We have got some serious concerns with too many people that have got drug and alcohol problems, and it is becoming an ever-increasing problem that the government has ignored. They need to be doing far more in addressing that very real concern, because if you cannot get them into the rehabilitation, counselling and other services, then really this issue will only be perpetuated and we will have many other drugs coming onto the streets and many other issues that will arise from that.

But in the case of these drugs that we are talking about in relation to prescription drugs or over-the-counter drugs that involve codeine and other substances, really this will give assistance to the prescribers and the dispensers doctors and pharmacists.

With those words I will conclude my contribution.



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