Ahead of the Therapeutic Goods Administration’s (TGA) decision to remove low-dose codeine medicines from sale over-the-counter (OTC) on 1 February 2018, NPS MedicineWise—an independent and not-for-profit organisation, is ensuring that Australians in culturally and linguistically diverse communities are aware of the changes.
The organisation has developed factsheets on the changes to codeine supply in Arabic, Simplified Chinese, Traditional Chinese, French, Greek, Hindi, Italian, Korean and Spanish. For those with an understanding of basic English, there is an Easy English factsheet with pictures. The resources were developed on behalf of the Department of Health and the TGA to explain that all codeine-containing medicines will move to prescription-only after 1 February this year.
Kerren Hosking, NPS MedicineWise spokesperson, says: “It’s understandable that some people, particularly those managing chronic pain, are concerned about all codeine-containing medicines moving to prescription only.
“Some people may be unaware of the changes, or that extended use of codeine or increasing their doses could harm them. There are too many cases of everyday Australians finding themselves in difficulty with these medicines.
“These factsheets simply explain why codeine is restricted to prescription-only — requiring a visit to the doctor — and people who’ve been relying on these medicines to treat ongoing pain can work with their doctor or health professional to develop more effective pain management plans and follow-up.”
Australians’ most commonly asked questions about the codeine changes and advice from NPS MedicineWise are below:
1. Why is access to low-dose codeine-containing medicines changing?
Codeine is an opioid drug, similar to morphine, and can cause opioid tolerance, dependence, addiction, poisoning and in high doses, death. Regular or inappropriate use of these medicines, for example to manage chronic pain, has led to many everyday Australians becoming codeine dependent without even realising it. The risks associated with codeine medicines are high and often outweigh the benefits of their use.
2. What about the people who can’t afford the time or money to see a doctor to treat their pain?
For short-term pain, such as a headache or a sports injury, a pharmacist can advise about suitable OTC treatments that can be just as effective as those containing low-dose codeine. However, for pain that is more severe or longer-lasting, a doctor or allied health professional (e.g. physiotherapist) is better placed to develop a more effective approach than OTC codeine-containing medicines. In the long run, this approach should save the patient paying for ineffective or harmful dosages of codeine.
3. Why is everyone being penalised for a small minority who abuse these drugs?
The Therapeutic Goods Administration (TGA) made the decision because of the potential risks and harms associated with codeine-containing medicines. Other countries, including the UK and France, have successfully implemented this change. By making codeine prescription-only, it reduces people self-medicating with codeine and protects others from future harm.
4. If codeine is so dangerous, why is it still available on prescription?
With codeine restricted to prescription-only, and requiring a visit to the doctor, patients and doctors can agree on pain management plans and follow-up. This has the potential to reduce the chance of people developing problems that can arise from self-medicating with codeine-based medicines, such as dependence and other serious side effects.
5. People suffering stomach issues can’t take nonsteroidal anti-inflammatory drugs (NSAIDs), meaning the only option for these will be paracetamol – are there any other alternatives?
Paracetamol (e.g. Panadol, Panamax) is an effective pain reliever for mild to moderate pain. In fact, studies have found that the low dose of codeine in OTC pain relievers may not offer any benefit over paracetamol alone. Sometimes, the best way to manage your pain may not be a tablet at all. Your pharmacist or allied health professional will be able to advise about other treatments, such as heat or cold packs or, when appropriate, NSAID ointments, which may be used as an alternative or in addition to paracetamol, to help you manage your pain.
Got a question about your medicines? Call Medicines Line on 1300 633 424 (1300 MEDICINE) to speak with a health professional Monday to Friday 9am to 5pm AEST (excluding NSW public holidays). For callers who need an interpreter, they may call TIS on 131 450 and the service will call Medicine Line to translate questions and answers.
To see the factsheets visit https://www.nps.org.au/medical-info/clinical-topics/over-the-counter-codeine-changes-to-supply#resources
Media enquiries: Eve Hanks (02) 8217 9667, 0419 618 365 or [email protected]