A changing landscape


survey

Recent codeine survey reveals more consumers approve than disapprove of the upschedule – a shift from earlier surveys

An online survey of 1,028 randomly selected Australian adults conducted from 10th to 13th November has found about half (49%) of respondents support the decision to make codeine prescription-only.

Meanwhile 36% oppose the change, including 13% that “strongly disapprove”.

About 14% are undecided/don’t know.

More men than women supported the decision (52% vs 47%), while those aged 35-54 were least likely to support the decision and more likely to disapprove.

The highest percentage of “strong” disapproval (17%) was among the 35-54 age group.

The survey, conducted by Essential Research, found providing context to the upscheduling decision (i.e. mentioning that codeine is an addictive opioid only available by doctors’ prescription in many countries) raised the level of total support from 49% to 52%.

However despite additional context being provided, a full 15% of those aged 35-54 still “strongly opposed” the upschedule of codeine – a higher amount than the 13% in this age group that “strongly supported” it.

And while 37% of those aged 55+ opposed the decision, 55% supported it.

Young people had the strongest support for codeine going script only: a full 20% of those aged 18-34 “strongly supported” script-only codeine, and 21% “strongly approved” of the upscheduling decision.

Painaustralia, which commissioned the poll, says the results reveal that most Australian support rescheduling of codeine to prescription only.

“There are more effective alternatives to codeine for chronic pain,” it argues.

An earlier survey

These results differ from research earlier in the year that found most of the consumers surveyed (83%) opposed restricting OTC codeine.

However this research, published in the journal Drug and Alcohol Review, included about a third of consumer respondents (354) compared to the above study.

It also included 220 pharmacists and 120 GPs.

Of these, 70% of surveyed pharmacists opposed the upscheduling of codeine, compared with 31% of GPs.

How should doctors prepare?

Once codeine goes script only, the pressure will be on doctors to decide whether or not to prescribe the opioid – among other choices.

With about a third of consumers opposed to the upscheduling decision, according to the above survey results, this won’t be easy.

A new study published in JAMA Internal Medicine has found denials to requests of pain medication lead to significantly lower patient satisfaction of the doctor in question.

Further research suggests patients bring high expectations for pain control to their GP visits.

Doctors need to be trained to handle patient requests in a way that maintains satisfaction through engaging and informing patients, whether the request is fulfilled or denied, says Dr Joseph Ross, an Associate Professor from Yale University’s School of Medicine, in an accompanying editorial.

“We can train physicians to say no to other types of clinically inappropriate requests, while still reassuring patients and paying attention to their needs,” Dr Ross suggests.

What about pharmacists?

The PSA and the Guild have partnered together to create a codeine hub, with support resources to help pharmacists and pharmacy staff prepare for the upcoming change.

See the Codeine Resource Hub for more information.

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