Codeine deaths claim ‘doesn’t stack up’: Fact Check

RMIT ABC Fact Check has concluded Minister Hunt’s claim that making codeine prescription-only would save 100 lives a year doesn’t stack up to evidence

In a move that is sure to reignite the codeine upschedule debate, RMIT ABC Fact Check has examined the evidence behind Health Minister Greg Hunt’s claim that making codeine prescription-only would save 100 lives a year.

“Mr Hunt’s claim doesn’t stack up,” the Fact Check team concludes.

“There has not been any recent data to suggest that 100 Australians are dying every year from over-the-counter codeine products.

“The latest available data was published in a 2015 study covering 2000 to 2013, which showed that on average about 100 Australians were dying a year from all codeine products, both over-the-counter and prescription.”

RMIT ABC Fact Check points out Mr Hunt’s claim comes from a TGA estimate, which is based on an assumption that an increasing death rate seen in the early years of that research would have continued in the time since then.

“This is not accepted by experts consulted by Fact Check,” it says.

Experts contacted by Fact Check pointed to a 2015 study, ‘Trends and characteristics of accidental and intentional codeine overdose deaths in Australia’, which found there were 1437 deaths linked to codeine, both prescription and over-the-counter products, between 2000 and 2013.

This amounts to an average of around 103 deaths per year.

“In any case the study was unable to determine the source of the codeine involved in 60% of the deaths,” said the Fact Check team.

“In the 40% where the source could be determined, over-the-counter products were involved in 40% of cases.

“That means over-the-counter codeine was only conclusively found in 16% of all the deaths reported in the study, or 16% on average.

“It appears that Mr Hunt and the Therapeutic Goods Administration have used the study’s findings to assume that over-the-counter products were involved in 40% of all codeine-related deaths.”

Image credit: ABC News
Image credit: ABC News

Fact Check is funded jointly by RMIT University and the ABC, and works to determine the accuracy of claims by politicians, public figures, advocacy groups and institutions engaged in the public debate.

The team’s verdict provides vindication for the anti-upschedule team, which has been persistently adamant that the claim was wrong.

“I am not aware of any study or data which backs up this claim – which is misleading, defamatory to pharmacists and must stop,” Pharmacy Guild NSW Branch president David Heffernan said in January.

“If there is any data to back up such an overblown claim, those making the claims should produce it – but I doubt that they can because I do not believe it exists,” he said.

University of Sydney’s Professor Peter Carroll countered the claim, saying he disputed the 100 deaths a year statistic and that the “vast majority” of people used low-dose codeine safely and appropriately for acute pain.

“In the debate regarding the upscheduling of low dose OTC codeine-containing products I had a number of conversations and email contacts with Mr Hunt where I advised him that I believed his claim was inaccurate, and that he had been misled by the TGA,” Professor Carroll told AJP.

Professor Carroll says the majority of the data referred to in the TGA’s claim was collected before codeine products were made Schedule 3 (May 2010), and no data was collected after the introduction of MedsASSIST (February 2016).

“They give no figures for the past four years, and include data collected a decade or more ago,” he says.

“It seems meaningless to quote any figure as to the best of my knowledge there is no evidence to show what the current figure actually is.”

Professor Carroll believes Minister Hunt and the TGA should “publicly admit that they were using outdated data” on which they based their codeine claims.

See the full verdict here.

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