Victorian public health experts have warned an influx of the opioid fentanyl will result in thousands of overdoses due to the state’s ill-equipped drug therapy system.

Fentanyl is wreaking havoc in the United States, with the Drug Enforcement Agency reporting nearly 80,000 deaths from the substance in 2022 – claiming it to be the nation’s deadliest drug.

While fentanyl is yet to reach Australia en masse, the Australian Federal Police have intercepted several large shipments of the drug and have said international cartels see Australia as an attractive market.

John Ryan, a public health researcher who conducted a recent report on the North Richmond Safe Injecting centre, said Victoria’s drug replacement therapy system was lagging behind other states and would bear the brunt of a fentanyl crisis.

“We’ve often followed the American market, but not always,” he said.

“We’ve never had a problem in Australia. They have a huge problem in the US. So we might not get a fentanyl problem. But it’s a 50-50, in my view

Not enough prescriptions for opioid replacements

Currently, Victoria’s most destructive opioid is heroin, and the state’s current system encourages addicts to seek out treatment where replacement medications such as methadone can be prescribed by a doctor or highly trained nurse.

But Mr Ryan said there was a critical shortage of GPs prescribing methadone, meaning too many addicts seeking treatment were falling through the cracks and were vulnerable to relapse and overdose.

“It’s actually quite difficult to get onto opioid substitution treatment in Victoria,” Mr Ryan told 7.30.

“Potential patients find it very difficult to find a doctor. The doctors that are doing it are incredibly busy and not necessarily able to provide the holistic care that those patients need.”

One GP who does prescribe methadone, Paul MacCartney, agrees there are not enough medical professionals in Victoria prescribing opioid replacements and he often sees patients who have been on waiting lists to receive specific addiction treatment for several months.

“Every GP clinic in Victoria is allowed to prescribe for up to five people buprenorphine treatment for opioid dependence. The number of GP practices that do prescribe is very low,” Dr MacCartney said.

“There’s a perception that these people are going to be hard, complex. And GPs are busy enough — they’re seeing enough people, you know, their books are already full, if you like. 

“Victoria’s drug of choice in the illicit market is heroin, more so than New South Wales. And yet in Victoria, we have about 7,000 or 8,000 fewer people in treatment than in New South Wales.”

Dr MacCartney is urging the state government to increase its funding to private clinics and hospitals to ensure they have the capacity to treat what he believes is a huge demand in addicts seeking treatment.

He also shares similar concerns to John Ryan and is fearful a fentanyl influx will have devastating effects in Melbourne.

“Our fear is that, like in North America … there’ll eventually be a flood, and the flood will be with fentanyl,” Dr MacCartney said. 

A spokesperson for the Victorian government told 7.30 it had spent $370 million on drug and alcohol treatments, which included $10 million for opioid treatments — but the money was covering the gaps left by the federal government as drug replacement therapy is covered under Medicare and is the responsibility of the federal government.

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