Why I’m losing codeine sales


woman taking pill

If you’re not using MedsASSIST, you’re helping neither patients nor pharmacy, writes Samantha Kourtis

Since MedsASSIST was rolled out and I decided to use it in my pharmacy, I’ve experienced a significant drop in OTC codeine sales.

It’s not because we’re refusing sale. We actually have not found a reason to refuse supply in the last two months, because our intention is to build rapport, and thus build a relationship with our patients and their doctor to achieve a good health outcome.

Refusing supply isn’t going to achieve that. So the approach we’ve taken is to record the sale and work with our customers to help them address their problems.

Instead, we’ve attributed our decline in sales to a reluctance from the consumer to show their driver’s licence and have the sale recorded. Customers have started saying, “I’m not showing my licence; I’ll get it from the other pharmacy where they don’t record it”.

The problem is that while we’re using MedsASSIST, surrounding pharmacies in our community aren’t.

In a way, it’s been good to see a reduction in codeine sales. We’ve helped patients towards improved clinical outcomes, and had some impact on patient use of codeine. There’s already a handful of great stories out there as a result of MedsASSIST.

But until MedsASSIST is nationwide and compulsory, we will not necessarily have the impact we want, because consumers know that they can go to certain pharmacies and not have the purchase recorded.

In my first month of recording, I had patients who thought I personally was monitoring their codeine use. I’d been seeing them maybe weekly, but when I brought up the list, found that they’d been shopping daily at other pharmacies.

So MedsASSIST has the potential, like Project Stop, to open our eyes to the challenges our patients face. It must be exhausting and very stressful to have to go to multiple pharmacies every week to get medicine you perceive a need for, whether for pain, or if you’ve inadvertently become addicted in the course of treating pain.

MedsASSIST is a great tool to prove to the TGA and Government that pharmacy is well placed to monitor and support patients with pain and addiction to opioids. But until we’re all using it, like Project Stop – and we all know how long that took to roll out – it will not achieve the outcomes we want in the numbers we need.

I think that some pharmacies have chosen not to implement MedsASSIST because they perceive IT issues, workflow issues and loss of sales; some may be arcing up about another Guild-endorsed program.

However, if codeine does go prescription-only, there will be impact to your front of shop turnover. Your profitability on painkillers will decrease and your workload will increase. Imagine if all that codeine now had to come through the dispensary!

But more importantly, the impact on patient outcomes would be huge.

In many places in Australia, you can’t get in to see a GP for two weeks. The medicine will become more expensive for patients – on top of GP fees for those whose GPs do not bulk bill – and we as pharmacists and doctors already know that people who want to misuse codeine and opioids at an S4 level already do it.

They doctor shop, they present to Emergency and they buy it off the street already.

As well, there is strong evidence that doctors would be more inclined to prescribe higher doses of codeine than those currently available over the counter.

This would also really disadvantage those who have an accurate diagnosis of their pain, such as period pain or migraine or joint pain that responds to these low doses of codeine, and who are using the products sparingly and appropriately without needing to see a GP.

I wish everyone would stop thinking short-term and focus on the bigger picture, and what we’re trying to achieve here. Because codeine going prescription-only will not help anybody at all.

I am feeling a loss in my sales right now. And I know that the day codeine goes prescription-only because pharmacy didn’t get on board with this monitoring tool, the loss to my sales will be phenomenal.

But it’s more important that we’re careful with this issue as a health profession. We shouldn’t be focused on the dollar; we should be focused on patient outcomes.

I can’t see how patient outcomes would be improved with codeine being restricted to prescription only.

And from a professional perspective, pharmacists need to shout aloud from the rooftops that we are perfectly competent and capable of dealing with codeine in the S3 environment.

Refusing to implement MedsASSIST is doing exactly the opposite.

Samantha Kourtis’ pharmacy, Charnwood Capital Chemist, was the 2014 Pharmacy of the Year. Kourtis was also named ACT Telstra Businesswoman of the Year 2014.

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40 Comments

  1. Tony Pal
    08/06/2016

    OTC Paracetamol + Codeine, whether effective for all, some or none, gives customers with ongoing pain, a reason to see their pharmacist. Should it go S4, these customers can still seek pharmacist advice, but some may go what is the point. Maybe side-stepping the pharmacist is their best option e.g. for severe pain, but maybe some customers would benefit from non-pharmacological advice, a back brace, a heat rub, etc. OTC P+C is getting bad press due to those seeking it for the wrong reason, but did they start because of a habit from prescribed opioids, illicit drugs, or because pharmacists were careless with issuing their first ever dose of low dose P+C. If the pharmacist was not the cause, why punish the pharmacist. MedsAssist is a useful tool, along with instinct, diplomacy and care that should be benefiting customers not ostracising them.

  2. David Haworth
    08/06/2016

    Good post Samantha but can I point out that ” Imagine if all that codeine now had to come through the dispensary!” has been happening for years in Queensland and is a fact of life up there. S3 goes into a basket in the script queue and is done when is got to. Prices are decently high too.

    • Samantha Kourtis
      08/06/2016

      Good point David – MedsASSIST is effectively achieving this now in my pharmacy. QLD has already demonsrated that this can be effectively managed as a S3R with MedsASSIST creating transparency across multiple purchases. I expect that the next step Nationally is for codeine to go through the dispensary as an S4. Something we can certainly manage but the extra step for the patient to see the doctor for a script is the challenge for the health care system and patient outcomes.

  3. william hau kin so
    08/06/2016

    Since I use the MedsASSIST, I also discovered a regular Nurofen Plus customer who I used to see on the 15th of every month is in fact buying them every week from 3 difference postcodes. After I offer to speak with his GP about better pain management, he had NOT SHOWED up for 2 months now.

    • Ouija1210
      15/04/2017

      Does this surprise you? people like their private health to be private. They don’t like the intrusion into private matters even if that person may be dependant on the said medication. These are very private and personal issues which require a much subtle approach. If you think you are going to help that person by refusing a sale or trying your detective skills on you are wrong.

  4. Nicholas Logan
    08/06/2016

    Good article Samantha. The only hope remaining for S3 accessibility for codeine combos is MedsAssist data.

  5. PharmOwner
    08/06/2016

    Can’t agree enough with Samantha about EVERYONE getting on board. If only some pharmacies use MedsAssist, it doesn’t take long for word to get around about which pharmacies to go to where you don’t have to show your ID. I too, have discovered a patient buying Nurofen Plus on a weekly basis from different postcodes. The purported reason each time according to MedsAssist was period pain. I’m not sure what the pharmacy prior to mine thought about a patient having weekly periods. I refused the sale, advised the young lady why (concerned about what that amount of ibuprofen was doing to her GIT and kidneys), offered her alternatives and contacted her GP to advise of the OTC purchases so that the GP was kept in the loop.

    • Ouija1210
      15/04/2017

      You contacted her GP without her permission? this is illegal. You could lose your licence and your job because of this. Even GP’s are not allowed to divulge information regarding their patients as its a part of patient/doctor confidentiality. What and who gives you the right to contact that persons GP without her permission to raise your concern even if valid? wow….

      • Jarrod McMaugh
        16/04/2017

        Ouija, the privacy act specifically allows it, and our practice guidelines require it.

  6. Julie
    10/06/2016

    I disagree with this program as a suffer of back pain plus the irregular heavy period bleed I suffer from. My doc advised over-the-counter pain meds. I would think she know better then most what type of pain meds are suitable for me. I honestly think that more then most people are not drug addicts but your actions are implying that if we need pain meds then there is something wrong with us. From what I can tell by reading about the issue is your fear that people will become addicts that’s the short of it. But what you are really going to create is a deadly underground substitute, that’s why we have such a drug problem in our country, people will always find a way.

  7. Guy
    11/06/2016

    Is there anyone out there who is fed up with the nanny state that Australia has become? The pharmacy boards no longer want us to compound if the item can be done by a factory. That’s really saying they don’t trust pharmacists to compound now, despite it being what they are trained to do. We are peppered with ads telling us not to cross flooded roads, not to go near fallen power lines – in other words, don’t take any sort of risk ever. Be compliant, and non-questioning. Governments love a docile population – they certainly did in the Eastern bloc of communist dictatorships in eastern Europe. Where is our freedom to choose? Or is that concept considered subversive now?

    • Helen McCormack
      18/06/2016

      Pharmacists are not qualified to determine a patient’s degree of pain as the patient is the only person who can really know. If you do not provide your drivers license the codeine pain relief is refused (invasion or privacy?). The need for codeine pain relief should be determine by Yout doctor and made prescription only. Pharmacists control of codeine products is irrelevant.

      • Peter Crothers
        18/06/2016

        Are you a doctor? What patronising doctrinaire nonsense. Pharmacists can determine peoples’ subjective pain just as easily and effectively, and using the same tools, as doctors do, As you suggest, there is no objective measure. And we are more likely to treat the patient as an individual with genuine care needs rather than just an “issue to be resolved”. MedsAssist is not mandatory and so there can be no invasion of privacy. Do doctors treat anonymous patients? Of course they don’t. MedsAssist is a tool to get to know patients’ clinical needs better and refer them where necessary to where they can get more assistance. And in any case, this whole codeine overuse fiasco is of doctors’ making in the first place – there is hardly a single ‘problem user’ who hasn’t been prescribed Panadeine Forte in the past, often in stupefying quantities. Many of these people are trying to escape the iatrogenic nightmare they find themselves in by seeking lower codeine alternatives to PanFte, and long ago lost faith in the medical system that seems to have no faith in them.

        • Helen McCormack
          06/07/2016

          No, I am not a Doctor. I have a medically diagnosed condition that requires pain relief, mostly at night. A pharmacist refused to supply this pain relieving medication without recording my drivers licence. Furthered I was told they would only supply the drug if I had a prescription from my doctor. I do not require a high dose of medication and have had no issue in the past. A pharmacist is not qualified to refuse pain relief as they are not privy to my medical history. So, to avoid these situations and leave people in pain ( which is not treating the patient with genuine care needs). I believe codeine would be best made prescription only medication. Therefore,the pharmacist would not need to make subjective and inaccurate assessments.This make a patient, namely me ,feel resentful by the assumption that you are being being mistaken for some sort of addict.
          Helen McCormack

          • Ouija1210
            15/04/2017

            You are right… either make it prescription only for all, or get off our backs. Pharmacists are not medical doctors. They haven’t had an ounce if training required to become a physician. Their job is to dispense the medication and follow the protocol created by the state/government. They may answer questions on differences between some medications and how to apply/use them but they have no ability to asses and diagnose someones level of pain or requirement for medication. Many of them think they do and there is a problem. A friend of mine who has a chronic neuralgia a nerve pain that is excruciating at time ran out of his regular meds so he walked into a pharmacy to ask for some codeine to get him over the weekend. He was refused this medication based on his appearance, while a woman before him bought a box of codeine without having to give a drivers licence… when he raised this issue with the pharmacists they said they could not help him if he does not provide his drivers licence. He refused and walked out. Went to a pharmacy across the road bought a packet of codeine without being asked for licence went back to the original pharamacy showed them the packed and told them that they were lying to him when they said it was compulsory to show drivers licence…. this made a scene and I’m pretty sure that it embarassed the entire pharmacy staff….

          • Jarrod McMaugh
            15/04/2017

            Ouija clearly you are very frustrated, but you seem to be misunderstanding a few things.

            Pharmacists are trained in medication – more so than doctors. Clearing up this misunderstanding may make some of the other issues seem less like detective work and more like gathering an adequate history.

            Codeine has only ever been for the treatment of acute pain without a prescription. If people have ongoing chronic pain, this always requires a prescription, and being able to see a clear history for a patient is essential to assisting with this. Currdntly, the only system for doing this requires the use of a driver’s licence. Not perfect, but it’s the best we have

            You should also.know that you are completely entitled to access those records. If you want to see them, please request it and you will be assisted in this request.

            You are also correct in saying that a person can use whatever substance in whatever way they see fit…. But they don’t have the right to unimpeded access. Pharmacists provide medication for specific conditions in specific circumstances…. And their clinical role in this area means they have a duty of care to individuals not to supply when there are safety concerns. This includes when the person is making an informed choice about how they use any substance they obtain.

            Your personal freedom to.access medications needs to be balanced with the pharmacists legal obligations and the statutes around that supply. If all three of these aren’t in concert, then you’ll encounter a deeper discussion with the pharmacist.

            Lastly, just like any other person selling anything…. A pharmacist has the right to refuse to sell you anything at any time, regardless of your rights to access. Basically, your rights aren’t unopposed in any transaction, whether your in a nanny state, totalitarian state, or perfect capitalist democracy. That’s life!

          • Ouija1210
            16/04/2017

            Refusal to sell an item can land you in some deep water. You said “like any other person selling anything pharmacist has the right to refuse sale” Lets place a hypothetical scenario, lets say a person suffering from chronic asthma keeps coming to a pharmacy and asking for asthma puffers etc…. and the pharmacist gets suspicious that person is using the medication for something else and refuses to sell. That person goes into an asthma attack and ends up in hospital etc… he has the right to sue the pharmacist for refusing to sell him/her medication. Of course this goes for OTC medicines. I’ve seen pharmacists refuse codeine to people who look “scruffy” or who may look like they are potential abusers. Again this is called discrimination. I’m currently finishing my phD and many times after I go home from a hospital I will pop into the pharmacy to get my nasal spray and rikodeine for bouts of dry coughs which may last for months on end and then they go away. Every time i show up in a tie and ask for these medications they never ask me for drivers licence. Several times I would wear tracksuit or hoody and guess what “drivers licence” please…. so its a form of discrimination, I have noticed it and I don’t work or deal with pharmacies. Its visible and its annoying.

          • Jarrod McMaugh
            16/04/2017

            I agree that it’s annoying, especially since the interaction you described isn’t the correct process. All schedule 3 products require the pharmacist and patient to have a discussion.

            I’ve been refused rikodeine and I’m a pharmacist… But I looked very unkempt at the time (had just travelled 3 hours home after a rock concert)…. It wasn’t good quality use of medicine or customer service… But it is the right of the retailer.

            You are right that refusal to sell carries its own medicolegal risk. In my practice, refusal to supply isn’t the end of the conversation… It’s the start of one. For your example above, the patient would be referred to a GP… Conveniently located on the upper floor with bulk billing.

            The issues you are raising aren’t actually about the right or wrong way to interact with a patient… They are about how this is done inconsistently. I share your frustration.

    • Roly Smith
      08/12/2016

      my local pharmacist is a chinese guy. He doesn’t understand that the entire extended family goes to this pharmacy and today he asked for my licence for a box of oanadeine. i’m nearly 67. I asked him why has no one here ever asked for this before in six years since implementation. He made out it was at every pharmacy and compulsory. I refused just like i refused to answer any chemists questions about my pain. I said that’s not your business. Which it is not. Argue this if you like, but i consider it to be an invasion of my privacy when other people are standing around.

    • Ouija1210
      15/04/2017

      Hi I agree with what you are saying except the one about eastern Europe. They had much more freedom there then we have here in Australia. Back there you can walk into a pharmacy and if you are in severe pain ask for tramadol type medicine (opoid anaglesic) and they will dispense it to you without doctors prescription. Specially if its late or if you are in severe pain. In Australia something like that is unheard of. Don’t get me on freedoms they enjoy in Holland, where mariujana is legal etc…

      • Willy the chemist
        18/04/2017

        Ouija1210 and Helen, I can feel your frustrations. At the same time, this issue have arisen out of the fact that Australia is a nanny state. Pharmacists are required or expected to “police” the sales of medicines…this just reflects the expectations of our society today. In my opinion, we have swung too far.

        Pharmacists are well trained to manage pain. We are not just robotic dispensers. However many pharmacists have adopt an overly cautious approach to supply because we are damned if we do and damned if we don’t.
        People, we happened to be the meat in the sandwich.

  8. Indifference Rules
    22/10/2016

    Making it compulsory to provide proof of identity to purchase an over the counter medication is another step closer to being a capitalistic Nazi state.. the government isn’t concerned about the peoples health..they care about the potential cost of bad health and boosting tax revenue.. the only ones to benefit from making these medications prescription only will be the Drs and tax department.. if the government truly cared about our health when it comes to mild painkillers they would of passed legislation for medicinal Marijuana .. but instead they do everything in their power to stop it.. Soon they will be wanting us to ‘heil’ the prime minister!

    • Ronky
      11/11/2016

      Do you also complain that it’s “a capitalistic Nazi state” when the doctor’s receptionist asks for your Medicare card, name and address, date of birth, medical history etc etc before the doctor will even agree to speak to you let alone prescribe anything for you? If not why not?
      You seem to think that there only two types of medicine- “prescription only” and “over the counter” with absolutely no rules applying to the latter. For over 100 years Australia has had at least 2 intermediate categories between prescription-only and “free sale anywhere no questions asked”.
      Your comment about marijuana is hilarious. Actually all of our governments are doing exactly the opposite – forcing legislation of marihuana for supposed medicinal purposes when all the evidence shows virtually no benefit of marihuana products for any disease. Certainly not as a painkiller. There are thousands of other herbs and substances which show more potential for possible future useful drugs than marijuana, but the governments have decided to cherry-pick marijuana, egged on by the Greens and other neo-Marxists who see it as the thin end of the wedge to force full legalisation of cannabis abuse.

      • Indifference Rules
        18/11/2016

        In reply to your opening question…Comparing the need to provide identification information, medical history and a medicare number with making codeine products a prescription only item is absurd.. in the last 5 years i have needed to visited my GP 3 times.. which took up approximately 5 and a 1/2 hours of my time for consultations that took approximately 25 minutes for all 3..2 were for post surgery check ups and the 3rd was to remove the wire and a surgical pin from my jaw because it had been broken in 2 places when i was sucker punched and mugged for my bicycle (i also had a fractured cheekbone and 2 broken teeth)…the 3 visits were over 13 weeks .. in those 13 weeks i had to buy a packet of Nurofen Plus once a week for 8 of those 13 weeks and several months later when i was having root canal work to try and save the broken teeth i had to again purchase Nurofen Plus a few times… I am self employed and have children.. if i had to see my GP just to get a prescription for the Nurofen .. even with repeats the hours i would of had to spend in waiting room sitting around idle would of been as absurd as your comparison.. and this is merely one scenario… what about the elderly and those with disabilities with mobility problems… making them go through the trouble of seeing a GP for cold/flu/ pain relief medication is irrational and unnecessarily cruel and like i said in my original comment… it benefits nobody but GP’s and the ATD…
        As for your comments on the medicinal uses and benefits of Cannabis/THC … Are you a Neurological or Oncology research Scientist? … How many Medical and Scientific journals do you read regularly? … if you are … by all means .. enlighten me.. if not… please keep your ignorance and single mindedness to yourself thanks!

      • Ouija1210
        15/04/2017

        I don’t know which country you come from but Doctors/Physicians are bound by their law the so called hippocratic oath which bounds them to heal and provide service to anyone even the enemy and to do no harm. So doctors will treat you even if you have no drivers licence or medicare card… they are bound by their oath. Second there are tonnes of medical journals which indicate serious benefits of cannabis use in all sorts of medical conditions. From cancers, chronic nusea, to anorexia to stimulate appetite. So buddy your comment when you said that there is no use for cannabis in medicine is not valid.

    • Ouija1210
      15/04/2017

      Actually if government really wanted to stop people from dieing from codeine related overdoses they would remove the amount of paracetamol from the codeine pills. Huge numbers of deaths related to abuse of over the counter codeine medications are actually not from the codeine itself but from paracetamol which is in the actual codeine pills. Paracetamol is poisonous to the liver and many of those who are addicted or dependant on codeine pills destroy their livers over time by ingesting high amounts of paracetamol not codeine. Majority of them die from liver failure or liver damage not codeine overdose.

  9. Nicholas Logan
    29/10/2016

    Had to mention here that ~70% of traceable codeine related deaths come from prescribed codeine. Therefore up-scheduling is not the answer. Management is the answer and MedsAssist is the best option for that so far.

    • Ouija1210
      15/04/2017

      Not really… if someone is a drug addict he/she will find a way. Most drug addicts will get their fix by buying from illegal source. As the matter of fact if the society realised that those who are addicted are not going to stop taking codeine just because one pharmacy refused to sell it to them… they will go another and another and if all pharmacies refuse them they will find an illegal source…. you can’t just quit your addiction over night… it takes months even years. As most of the addicted people are actually very sucessfull businessmen, professionals, tradies etc…. more of understanding and support less judgements.

  10. John
    10/11/2016

    People have been using pain relief on there on for thousands of years without doctors and pharmacists. We don’t need regulations, criticisms or judgements from anyone. Back off and leave people alone.

    • Ronky
      11/11/2016

      Oh well then, that was a waste of time by all of us studying for all those years to become pharmacists and doctors.

      • John
        11/11/2016

        I love study and learning, I do it all day everyday. Its what I live for. But that doesn’t mean you or anybody else in this world knows what’s best for me or has the right to inflict any judgements, criticisms or regulations against me. Just as I don’t have the right to beset anything upon you. How about I come around to your house and choose the clothes you wear and dress you as well. Communism. Fascism. Dictatorship. Democracy. It’s all the same in this world. Go and get some common sense and intelligence you jackass.

        • Ronky
          11/11/2016

          Actually I spend at most about 0.01% of my life commenting on this and other for a. I haven’t noticed anyone else here whose comments contained any self-criticism. Least of all your comments. I won’t feed your paranoia any more.

          • John
            11/11/2016

            Yeah you keep telling yourself that. It doesn’t feel very nice being on the other side, does it. You think just because it is the net, you can treat people anyway you want. Grow up and get some brains and compassion about you.

      • John
        11/11/2016

        Actually don’t even bother reading my reply. I just read some of your posts. You spend your whole life criticising other people but not yourself. People like you are one of the many problems of society.

  11. John Watson
    23/12/2016

    I am sick to death of the nanny state in Australia. So the gov is going to put getting a script for a low level pain reliever in the same basket as getting some zanax? Really? We all have to jump through hoops now,its ridiculous. Why is the AMA pushing so hard for this? How many extra appointments will the typical gp score out of this? I bet they have run the numbers. Please don’t tell me how altruistic the typical gp is. My gp charges me $80 just to say hello to him. He drives the latest 2 x mercs a sedan,4wd.plus the multimillion dollar home. If codeine is so evil why even write scripts for it? Why not have a sign in reception saying “we do not prescribe codeine for our patients”. Because its going to be a huge money spinner for them thats why!!. I nearly throw up when i hear the AMA saying its just for our own good. It seems we dont have the intelligence to take this properly. Maybe they will start on asprin next? Sort of like the guy from the tax office coming to audit you and he says – “trust me i’m from the government.”.

    • Ouija1210
      15/04/2017

      Imagine how the doctors will rake in with all the new visits from people who just need codeine for their back pain… imagine how many people will have to go see a GP to get a script for codeine just because government thinks its necessary…. jesus

  12. Ouija1210
    15/04/2017

    I personally refuse to show my licence at the pharmacy. If they refuse to sell me what I asked for I simply go to another one that does not record. We live in a control freak society and now days you need to register this, register that, sign up here, bla bla bla give your licence every time you have a back ache….. NO! I refuse to have my divers licence recorded and I have absolutely no idea what they are writing next to that record… they can write that they think I’m a drug addict, or that I’m suspicious or god knows what….. plus I have no ability to see what was written or recorded and for how long that record stands. NO! people really need to refuse to cooperate. Even though If I were an addict its my free choice… pharmacists are not doctors and are not medical professionals and many of them act as if they were…. specially the uptight pharmacy assistants who tend to barrage you with 100000 questions, and god forbid if they saw you buying a packet of codiene week before they immidiately go into a detective mode which is really annoying…so I tend to ask them if they are pharmacist if the answer is no I usually ask to speak to one and ignore them completely. I’m sick of society control, our lives are already controlled way too much by the government as it is. Maybe I’m acting this because I had to deal with identity fraud when I left my drivers licence at the petrol pump as I’ve forgotten my wallet and had to retriever it. Later i got $1600 worth of driving fines as someone used my licence number to transfer all their speeding fines. it took me months to correct this problem and the nerves it cost me was not worth it. So no i refuse to give my licence to anyone except the police, plus its my own private thing if I’m using codeine. Either make it prescription only for all pharmacies to comply or stop playing detectives.

    P.S – by the way I support the recording of pseudoephedrine products that has nothing to do with my rant regarding codeine.

  13. Ron Batagol
    17/04/2017

    So, what is the future of low-dose codeine-containing products?

    In acknowledging the positive outcomes of the Med Assist program, whilst lamenting that there could have been a higher take-up, I think there are 3 key issues which have not been emphasised enough in this article and in the subsequent discussion, namely:

    1.Whilst it has been well established that low-dose codeine is ineffective for pain relief, it is
    extensively documented here and overseas, that, even within the therapeutic dose range, those who are ultra-fast metabolisers can potentially be at risk of toxic adverse effects, because of the large individual variation in metabolism. –See “TGA Codeine information- frequently asked questions” –at:https://www.tga.gov.au/behind-news/codeine-information-frequently-asked-questions

    2. Even if there had been a higher take- up of Med Assist, taking into account the management within the community of the cohort of addicts who would be then unable to obtain further supplies of codeine-containing products, codeine addiction within the community, albeit at hopefully a lower level, would remain a community problem.

    3. The optimum necessary increased level of the professional advice given directly to patients by pharmacists, both before and after 2018, is increasingly going to be an even more vital component in the community management of pain relief, as NSAID and paracetamol, with all the attendant risk versus benefit considerations, become the mainstay of patient-managed analgesia.
    Can doctors manage these issues better than pharmacists?

    Probably not, but it seems to me that the drastic reductions in advertising of low- dose codeine-containing products prior to 2018, and then limiting accessibility to low-dose codeine products after 2018, plus, as the
    article suggests, the likely tendency for doctors to prescribe the higher-dose codeine products, are all going to inevitably lead to a vastly lower uptake of low dose codeine products.

    So I wonder how long low-dose codeine products will continue to be produced and available as commercially viable products on the market after 2018?

    One also hopes, without being overly-confident, that, out of all of this, the emerging imperative of increased pharmacist’s time required to give detailed clinical advice on the various therapeutic or specific to manage pain for each patient’s situation in the absence of OTC codeine options, will be appropriately recognised and remunerated as a dedicated entity of pharmacist clinical intervention and activity.

  14. David John
    04/05/2017

    Prohibition didn’t work with alcohol, however it apparently does with medications and drugs. This both baffles me as well as intrigues me. As long as you’re 18-years-old in this country, you can walk into any bottle shop and purchase 15 bottles of vodka if you so wish, and drink till you drop (or worse), yet some Panadeine extra for that headache or period pain? Not so quickly. F**king clowns dictating our lives.

    • Jarrod McMaugh
      06/05/2017

      The difference is, pharmacists are bound by legislation to establish a therapeutic need.

      It’s not illegal for you to buy medication for non-therapeutic use, but it is illegal for me to sell it to you for non-therapeutic use.

      Not selling it to you isn’t just about the ethics or protecting you from yourself, it is also about protecting myself from prosecution.

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