Codeine bans helped avoid a COVID spike in ‘deaths of despair’

Deaths of despair claimed the lives of almost 6500 Australians during the first full year of the COVID pandemic, new research shows, but a ban on over-the-counter codeine pain relief drugs helped prevent more people from dying.

The Centre for Population, a part of the federal Treasury, on Tuesday released its first examination into “deaths of despair” which have become a growing focus of attention by economists due to the factors underpinning the deaths.

A ban on over-the-counter codeine products has been attributed to fewer deaths of despair in Australia.Credit: Jason South

The United States has struggled with a surge in avoidable mortality, largely related to drug-induced deaths. In 2020, there was a 56 per cent increase in US deaths at least partially attributable to synthetic opioids.

The Centre for Population examined deaths by suicide, alcohol and drugs through the first stages of the pandemic when there were concerns by mental health experts that COVID-related restrictions could lead to an increase in self-harm or self-medication.

While such deaths increased in the US and the United Kingdom, the centre found deaths of despair in Australia remained relatively steady. Through 2021, 3.4 per cent of all deaths in the country were attributable to suicide, alcohol or drugs.

“[In] Australia deaths of despair have been more stable than in the United States, with no evidence of a similar increase in opioid-related deaths, and relatively low rates of alcohol-induced death,” it found. “Long-term trends in Australia did not accelerate.”

It found alcohol deaths did increase when sales of take-home liquor surged due to restrictions on hotels and bars.

“In Australia, the age‐standardised rate of alcohol-induced deaths increased 4 per cent in 2020, and another 5 per cent in 2021,” it found.

But drug-induced deaths fell slightly in Australia through 2020 and 2021 while increasing in both Britain and the United States.

The centre said part of this was due to restrictions on the sale of some forms of pain relief that were introduced in 2018.

“The reduction in Australia is likely due to decisions to restrict access to over-the-counter codeine preparations,” it found.

Australia had what the centre described as “relatively few” deaths induced by cocaine. In England and Wales, there were 1.5 deaths per 100,000 caused by cocaine compared to just 0.3 in Australia.

In the United States, the drug-induced death rate has increased fourfold over the past 20 years. Overdoses now account for 3.2 per cent of all deaths compared to 0.8 per cent in 1999.

During 2021, there were 3144 suicides in Australia with the rate of deaths slightly above that in England and Wales but below that recorded in the United States.

Through 2019 to 2021, suicide was the leading cause of death for people aged 15 and 44, but the largest number of deaths were among the middle-aged.

The centre noted that suicide rates across all three nations fell in 2020.

“In Australia, the use of mental health services increased in 2020, and there were pressures on mental health over this period,” it found.

Crisis support can be found at Lifeline (13 11 14 and lifeline.org.au), the Suicide Call Back Service (1300 659 467 and suicidecallbackservice.org.au) and beyondblue (1300 22 4636 and beyondblue.org.au).