Canberrans are grappling with severe medicine shortages that are impacting the quality of end-of-life care. Families are reporting that the unavailability of critical pain management drugs is leading to distressing experiences for terminal patients. The situation has prompted calls for reform and better resource management in the Australian Capital Territory (ACT).
The heartbreaking experiences of families like that of Alex Brown highlight the urgent need for change. Brown’s nephew, who succumbed to illness at just three years old, required extensive management of his end-of-life medications. Despite the efforts of four adults, they encountered significant difficulties. “We were grieving as a family, and medication should be something that is really easy. It shouldn’t be the hardest part of someone passing away,” Brown remarked. “Everything that can go wrong did go wrong.”
Impact of Medicine Shortages on Palliative Care
Since the introduction of voluntary assisted dying laws on November 3, 2023, the state of palliative care in the ACT has come under scrutiny. Camilla Rowland, Chief Executive of Palliative Care Australia, expressed concern that many individuals are suffering needlessly during their final days. Board chair Peter Allcroft specifically pointed to the shortage of potent opioids like morphine as a significant issue. “To see a loved one die in distress, restless, agitated because of pain and angst, it leaves a significant legacy, and we will have let that family down,” he said.
Pharmacist Alex Brown has witnessed the emotional toll of these shortages firsthand. Patients often arrive distressed, as medication supply issues arise unexpectedly. “There’s a lot more stress, there’s a lot more anxiety,” she noted. “It is truly heartbreaking when I get somebody who brings a script in, and you can clearly tell they’ve been crying.”
Global Trends Affecting Local Care
The problem of medication shortages is not confined to Australia. Globally, the increasing awareness of addiction and misuse risks has led to fewer doctors prescribing opioids. Consequently, pharmaceutical manufacturers are reducing production of these vital medications, impacting smaller markets like Australia. Allcroft emphasized, “Children are dying without adequate pain relief,” underscoring the dire situation faced by terminally ill patients.
Patients nearing the end of life often require not just pain management but also medications for symptoms like nausea and difficulty breathing. Brown’s nephew was prescribed fourteen different medications at the end of his life. With limited options available, including those subsidized by the federal government, the situation is critical. “There are fewer options, and with end-of-life situations, things can change really, really quickly,” Brown explained. “Suddenly, I might not be able to swallow, so if the script I have is for a tablet, I’ll need to get another script for a liquid. If the liquid’s out of stock, what do I do?”
Moreover, the necessity for consistent pain management complicates matters further. “Chopping and changing medications becomes really risky,” she added.
As the situation unfolds, Allcroft argues for the need for all end-of-life care medications to be made freely available to alleviate the burden on families. He advocates for Australia to consider manufacturing its own medications, noting that the country already produces about half of the world’s opium supply, primarily in Tasmania.
Brown also emphasizes the need for better communication among healthcare providers, patients, and the public health system. “People might be prescribed different medications by a GP, hospital, and hospice nurses,” she explained. “They end up in hospital anyway because they didn’t know how to manage it, which is such a waste.” This disorganization can result in extreme trauma for families who witness a loved one suffer without adequate care.
“Imagine the pain that person is in, and then everyone around them watches that person die in pain,” Brown said. “It’s so preventable, and to have a comfortable, safe, lovely death is what everyone deserves.”
As the ACT navigates these challenges, it becomes increasingly clear that reforming palliative care and ensuring the availability of necessary medications is crucial. The goal must be to provide compassionate care that respects the dignity of those nearing the end of life.
