World Evidence-Based Healthcare Day 2021

This global initiative raises awareness of the importance that high-quality evidence informing healthcare policy, practice, and decision-making has in improving health outcomes. It is also a time to reflect on challenges and ways in which we can do evidence-based healthcare better.

In Australia and many other places, it is fair to say that we need to do better when it comes to evidence-based policy on alcohol and other drugs (AOD). Policy-based evidence, rather than evidence-based policy, is far too often the reality.

While there is always a need for more research, on many AOD issues we already have a strong evidence base to inform necessary public policy change, and yet in many cases change hasn’t happened, or progress has been slow. There are many reasons for this, but among them is that addiction remains one of the most stigmatised conditions worldwide, and public misconceptions about addiction limit the political capital required for public policy change.

It is difficult to implement medically supervised injecting rooms when stigmatising views of people living with addiction limit the public’s empathy toward people who would benefit from, and indeed whose lives could be saved by using such facilities. It’s why despite mountains of evidence accumulated over decades supporting the establishment of medically supervised injecting rooms, we still only have two in Australia.

We know supervised injecting rooms link people with the help they need and save lives. Implementing these facilities might not be popular, but it is the right thing to do, and governments that have done so are to be credited for doing the right thing even when it was difficult. That’s the true test of political leadership.

What other evidence-based changes could our political leaders make that would have a meaningful impact on the lives of people living with substance use or addiction and their families? There are many, but one area we can do better is in the provision of evidence-based opiate dependence treatment.

As Turning Point and the Monash Addiction Research Centre outlined in our recent submission to the public consultation for the post-market review of Opiate Dependence Treatment Program medicines, evidence indicates that opioid-related overdose deaths are increasing while access to evidence-based opioid dependence treatment (or pharmacotherapy) remains difficult.

Varied approaches to treatment for opioid dependence by states and territories have resulted in significant differences in the accessibility of treatment. We must adopt a national approach with standardised dispensing and supply arrangements for evidence-based pharmacotherapy for opioid use disorder. We must also make it more accessible, such as by reducing the cost burden on consumers and requirements for daily attendance for dosing. Pharmacotherapy remains cost prohibitive for many, and daily dosing requirements present a significant barrier to treatment, especially for those from rural and regional areas.

Just like people don’t choose to be diabetic or asthmatic, no one chooses to become dependent on certain substances. This World Evidence-Based Healthcare Day, let us remember that opioid dependence should be treated like diabetes, asthma, or any other chronic health condition – free from stigma and with the best evidence-based treatment and support available.

Professor Dan Lubman AM is a Professor of Addiction Studies and Services at Monash University and Executive Clinical Director of Turning Point.

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