Codeine concerns

Pharmacists share their top concerns about the upcoming schedule change in an AJP poll

Readers were asked what they were most worried about once codeine-containing analgesics go prescription-only in February 2018.

Respondents could choose more than one option. With nearly 300 respondents and over 1200 votes, the top concerns were:

  1. Patients moving onto stronger, more dangerous alternatives (64% of respondents)
  2. People will be prescribed stronger doses of codeine (61%)
  3. Angry/unhappy patients (55%)
  4. Doctor shopping (52%)
  5. Feeling helpless in recommending products to patients (46%)
  6. Loss of counselling opportunities about pain management (35%)

Leading the pack was the concern that patients will be moved onto stronger, more dangerous alternatives for pain management.

“Every time access to a ‘recreational’ substance has been impaired it has caused a flood of users to other more harmful options. Every time, without fail,” wrote reader Andrew.

“A huge cohort of undertreated pain and opioid-loving patients will be scratching around for an alternative.”

“The only way to really fix this is to have an alternative to codeine come off s4 to s3, as many people cannot use an anti-inflammatory,” said a reader on the AJP Facebook page.

“Patients currently laugh at me when I recommend paracetamol… what is it going to be like when we have no other options?”

A top concern was also people being prescribed stronger doses of codeine, with some suggesting low-dose codeine products may be taken off the market.

“What person with temporary but acute pain that may have been happy with low dose Codeine is going to be satisfied after spending the time & money to see a doctor to walk away with a low dose instead of high dose Panadeine script?” said a reader.

Angry and unhappy patients followed closely at third, with pharmacists potentially facing a deluge of irate customers who will not be able to easily access codeine products the way they used to.

Less than a third of respondents were concerned about loss of income (30%), while a similar amount did not like the idea of more time spent dispensing the same products once they’re S4 (27%).

Lagging behind were the concerns: loss of autonomy (23%); loss of trust with patients (19%); loss of product lines (18%); and dealing with stock issues (12%).

Promising news

The Health Minister has indicated support for a national real-time recording system for controlled drugs.

He told media he wants additional money for a nationwide electronic recording and reporting system “within the next six months”.

“I look forward to ensuring the electronic prescription system … is acted on in my first six months,” says Mr Hunt.

His support has been welcomed by the Pharmacy Guild, the group behind the recording system MedsASSIST which is currently still in place thanks to the minister.

“Coroners around the country have called for the introduction of a real-time recording system for controlled drugs, and the Pharmacy Guild strongly supports such a system,” Guild Executive Director David Quilty told News Ltd.

“While the States and Territories have made varying degrees of headway in introducing real-time electronic monitoring systems, decisive action is required to achieve a national system.

“We know that the Federal Government and the new Health Minister are keen to make this happen, and the Guild stands ready to assist in the implementation of such a national system.”

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