Shifting Opioid Patterns: The Rise of Fentanyl and Oxycodone in Australia
Fentanyl and oxycodone, the key players in the opioid epidemic sweeping across the United States, have begun to reshape the landscape of opioid use in Australia. While usage rates here remain lower than in the US, recent studies reveal a shift in opioid consumption patterns.
In this engaging article, we delve into the world of fentanyl and oxycodone, exploring their impact on Australia, tracing the evolving usage trends, and shedding light on effective workplace testing methods for detecting their presence.
Fentanyl vs Oxycodone
Fentanyl and oxycodone are powerful and highly addictive opioids commonly used for pain management.
What is Fentanyl?
Fentanyl is a synthetic opiate drug that is 80 to 100 times more powerful than morphine.
It is used medically as an intravenous anaesthetic and analgesic. However, it is most often encountered as a transdermal (skin) patch to relieve long-term pain, or to supply relief to cancer patients and the elderly. The drug is often misleadingly marketed as ‘safe’.
These patches are frequently discarded when they are around two-thirds used as the quality of pain relief tends to drop over time. Unfortunately, these ‘used’ patches can be reused by addicts when they extract the fentanyl gel. This practice is called ‘dumpster diving’ because they often search for old patches in the garbage. They then distil the pure drug from the patches and often recrystallise the drug to form “Rock.” Fentanyl distillates can be smoked, or the patches can be used directly – either being pasted on the body or chewed.
Traditionally fentanyl powder is often mixed with low-quality heroin. Heroin supplies from Central Asia are drying up. This is pushing users to experiment with fentanyl.
Additionally, increasing amounts of fentanyl are being imported into Australia. Just last year, the Federal Police in Melbourne seized a shipment of fentanyl equivalent to 5 million individual doses.
What is Oxycodone?
Like fentanyl, oxycodone is a synthetic opiate often sold as Oxycontin or Endone which, when taken by mouth, is one-and-a-half times more potent than morphine.
Medically, it is used for managing moderate-to-severe acute or chronic pain and is normally sold as a controlled-release tablet to be taken every 12 hours. As with all opioids, oxycodone induces euphoria and is addictive.
Oxycodone is one of the most abused pharmaceutical drugs in the US and is significantly abused in Australia, although not (as yet!) at levels approaching those in the US.
Once a person becomes physically dependent on oxycodone, they experience strong cravings for the drug, leading to continued use despite the ongoing physical harm. They are also at risk of suffering severe withdrawal symptoms, which can include panic attacks, nausea, muscle pain, insomnia, and flu-like symptoms.
Overdoses can easily be fatal. When not fatal, they can cause spinal cord infarction and ischaemic brain damage that resembles a bad stroke. Oxycodone also interacts badly with many other prescribed drugs – especially some anti-HIV medications – which can substantially slow the rate of clearance of the drug from the body.
Combining Opioids With Stimulants
Oxycodone and fentanyl are now being increasingly used in combination with stimulants – especially of the amphetamine class (which includes Meth).
There is a long history of people combining opioids with stimulants, such as ‘goofballs’ combining methamphetamine with heroin and ‘speedballs’ which are a heroin plus cocaine mixture. Australia already has a widespread Meth problem, and the number of cases where opioids were combined with Meth is rising.
Oxycodone and Fentanyl Usage Trends in Australia
There is a growing opioid abuse culture in Australia.
Even in 2008, the National Drug & Alcohol Research Centre reported that 91% of injecting drug users in Australia report having used Oxycodone. 23% admitted to using it in the last 6 months.
Fentanyl use has been rising in Australia, especially over the last 4 years – most notably on the Sunshine Coast in Queensland. Programs to stop fentanyl use have been only partly successful as addicts often switch over to oxycodone.
Oxycodone and fentanyl use in Australia is substantially higher in regional areas than in urban and capital areas, but the overall use rate is significant in both areas.
Worksite drug testing has shown that the use of these drugs varies substantially over the week. In remote sites, importation may occur only on specific days – which is then reflected in higher capture rates over the next 24-48 hours.
Cracking down on one opioid – such as oxycodone – only appears to encourage users to switch to another opioid: specifically, fentanyl. This was seen in the closing years of the last decade in Queensland where a crackdown on oxycodone led to a rise in fentanyl abuse.
Surging Popularity of Fentanyl and Oxycodone: Examining the Pros and Cons
What is the danger if oxycodone and fentanyl use are on the rise?
Both fentanyl and oxycodone carry a high risk of making users dependent on the drugs, and both have what is called a narrow therapeutic window: a dose sufficient to bring on a high is not much less than the dose required to give a potentially lethal overdose.
The appeal of fentanyl and oxycodone is that the drugs are pharmaceutical – so they have a high purity, and users are less worried about contamination. The drugs are highly potent – ‘more bangs for the buck’ – and because of their rapid uptake cause a ‘quick high’ (especially fentanyl).
The advantage from a medical perspective is that fentanyl can be taken when a patient has an impaired liver, to treat neuropathic pain, and the patches can be used when a patient is nauseous, vomiting or has difficulty swallowing. For the user, the big attraction is that fentanyl is the fastest-acting opioid available.
Fentanyl is cheap – so it is a popular opioid for abuse. Unfortunately, it also has the most prolonged respiratory depression (suppression of the breathing reflex) of any opioid – which arguably makes it the most lethal.
Workplace Drug Testing: Detecting Oxycodone and Fentanyl Use
Common workplace drug testing methods include:
- Urine Drug Testing – Oxycodone and fentanyl can be detected in a specifically requested assay in urine. Urine is the superior sample for both drugs, as the detection window is much greater than oral fluid – up to 4 days.
- Oral Fluid Drug Testing – Oxycodone is included in routine oral fluid screening tests, unlike fentanyl which is not included in these tests. The detection window for oral fluid is 36 hours.
- Wastewater Drug Testing – Wastewater drug testing is the best way to get a snapshot of the extent of actual opioid use at a workplace but should include weekend coverage as use varies greatly day-to-day.
Safework Health offers the convenience of on-site instant drug testing at your workplace or at any of our nationwide clinics. Additionally, our extensive network includes a suite of NATA-accredited drug testing laboratories.
Notably, Safework Health stands out as one of the select few laboratories in Australia capable of conducting urine testing specifically for oxycodone and fentanyl.
Feel free to reach out to us today for a discreet and confidential consultation.
Meet The Author
Dr Phil Tynan, National Chief Toxicologist
Dr Tynan, a distinguished Toxicologist and a retired Clinical Biochemist Pathologist, brings a wealth of industry knowledge and experience. He is considered an expert in testing for substances of abuse.
Dr Tynan primarily supports Safework Health in developing new drug assays and procedures. He also offers guidance to clients and expert clinical advice as needed.
Dr Tynan is a published toxicologist in internationally peer-reviewed journals and is available to provide advice and expert opinion regarding results, expert witness testimony and appearances at courts and tribunal hearings.