Codeine medicine will soon need a prescription from your doctor in a tightening up of pharmacy rules, but the move has been criticised for putting more pressure on overworked doctors and for stopping patients with genuine need from accessing the drug.
Codeine is an opioid, often found in over-the-counter painkillers, cough syrup, and cold and flu medicine. The Australia Alcohol and Drug Foundation says codeine can be found in popular medication including Nurofen Plus, Codral and Panadeine Forte. However, codeine can also be taken recreationally, either on its own or mixed into a drink, and the drug's availability is quite restricted in the U.S, Europe and other areas.
Earlier this year, Australian rapper 360 revealed his addiction to codeine, admitting to taking 90 pills including Nurofen Plus each day.
The Therapeutic Goods Administration on Tuesday announced that codeine medication would not be available without a doctor's prescription from 2018, restricting the supply of drugs currently available freely over the counter. After a review of the drug, the TGA decided to upscale codeine from an over the counter drug to a Schedule 4 prescription medicine.
"The change in scheduling of products containing codeine... will mean that people who wish to use painkiller medicines containing codeine will have to obtain a prescription from their GP or health care provider or use an alternative OTC product such as paracetamol, ibuprofen or a combination of these drugs," the TGA said in a statement.
"There are also a number of alternative OTC cough and cold medicines that do not contain codeine."
The system will not change until February 1, 2018, and codeine will be available over the counter until then. The TGA said the harms of codeine, such as addiction, compelled their decision and claimed other non-codeine drugs were just as effective.
"In making this decision, the TGA decision maker took into consideration compelling evidence of the harm caused by overuse and abuse of OTC codeine containing medicines, as well as the fact that the USA, most of Europe, Hong Kong, Japan, the United Arab Emirates and several other countries have already stopped codeine-containing products from being sold without prescription," the TGA continued.
"Low dose codeine-containing medicines are not intended to treat long term conditions, however public consultation indicated that many consumers used these products to self-treat chronic pain. This meant that consumers frequently became addicted to codeine."
"The TGA decision maker also took into consideration that there is little evidence that low-dose codeine medicines are any more effective for pain relief or cough than similar medicines without codeine."
However, the Pharmacy Guild criticised the decision, saying it would place further pressure on doctors. The guild's national president, George Tambassis, called the decision "short-sighted".
"The decision has purportedly been made to help stamp out abuse of these medicines by some people but in reality this measure will only encourage vulnerable patients to doctor shop and try to find ways around the system," he said in a statement.
"This decision will not address issues of misuse and abuse but rather will increase Government expenditure on the MBS and PBS with consumers forced to visit a GP to have a prescription written."
The Pharmacy Guild said a reporting system called MedsASSIST was already working well to record and track purchases of codeine, and stamp out abuse of the drug.
"More than 4 million transactions have been recorded since March when the system was introduced across Australia. Of these transactions, pharmacists have denied sales to some 70,000 patient because of identified risk factors. Nearly 50 per cent of patients denied a sale were referred to their doctor for more treatment," Tambassis said.
"Making these medicines Schedule 4 will simply create a barrier to the majority of consumers who use these products safely... Shifting it to prescription only without a mandated real-time recording system or any screening program will simply bury the problem even deeper in the overwhelmed system and cost shift it to an already bursting MBS."
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