As of the first of February next year, any medicines containing codeine will no longer be available to be purchased ‘over-the-counter’ in Australian pharmacies and instead will require a prescription. Medicines which include codeine as an ingredient include painkillers and cough, cold and flu products. The change will bring Australia into line with other countries including the US, most of Europe, Hong Kong and Japan which have all banned over-the-counter sales of medicines containing codeine. Some medicines may be removed from sale altogether as a result of changing the schedule from an S3 Over-The-Counter rating to an S4 prescription-only rating.
Consumers who feel they are unable to afford the cost or time associated with visiting a GP to obtain a prescription for such medicines are being advised by the NPS MedicineWise to consult with a pharmacist about suitable alternative treatments. Meanwhile the Pharmacy Guild of Australia is issuing fact sheets and guidelines to pharmacies to assist them on advising consumers of alternative medication and where it may be necessary to refer consumers to a GP.
Health groups are currently advising consumers who use codeine-combined medications on a regular basis to consult with their GP to discuss their options and formulate a plan. In general, Australian doctors are supportive of the restriction however there is a concern that visits to GPs or ‘doctor-shopping’ may increase as a result of the ban.
The reasons for the change
In October 2015 the Therapeutic Goods Administration (TGA) published an interim decision to up-schedule codeine to become prescription-only medicine based on the risk of addiction, and adverse events. The initial implementation date was delayed due to feedback from groups representing pharmacists, but the ban is now going ahead. The TGA have made the change in an attempt to reduce the rate of accidental deaths due to opioid use, which according to a report by the National Drug and Alcohol Research Centre, has more than doubled in the last decade among Australians aged 35 to 44.
The misuse of over-the-counter codeine products has also been identified to be a burden on taxpayers due to hospital admissions resulting from excess consumption. One five-year study showed that in some cases patients were taking up to five times the recommended daily dose of codeine-containing painkillers. In the period 2007-2011, 769 deaths were attributed to a possible codeine-combined product.
It is hoped that encouraging those who regularly use pain-relievers to visit their GP to formulate a pain management plan may reduce the chance of dependency and other side effects. Chronic pain sufferers may be able to access Medicare-funded care plans which allows them to access an allied health professional for treatment. Alternatively their GP may refer them to a pain specialist or pain management clinic.