The opioid epidemic in North America: Implications for Australia

The opioid epidemic in North America has attracted considerable international concern because of the scale of the problem and the high rate of overdose deaths. This paper explores the factors that have contributed to the opioid epidemic in the United States and Canada, and reviews the current situation in Australia. There is little evidence that Australia is on the same trajectory as the United States or Canada, or that fentanyl, particularly illicit fentanyl, has penetrated the Australian drug market as it has overseas. There is, however, evidence of an increase in harm associated with pharmaceutical opioids and heroin, despite a fall in heroin use. This paper highlights the importance of being vigilant about the potential for similar problems in Australia, and continuing to monitor key indicators of opioid availability, use and harm. Responses to opioid misuse and overdose must be relevant to the Australian context.