Codeine decision expected within weeks

Will the success of MedsASSIST be enough to prevent the upscheduling of OTC codeine products?

At the ASMI conference in October, Health Minister Sussan Ley suggested a final decision on the scheduling of codeine will likely be delivered before the end of the year.

Currently the Department of Health is completing a regulatory impact statement on the proposals and a decision will be made public before the next round of scheduling decisions are announced.

News Corp publications have also been reporting that a decision will be passed down within weeks.

NSW pharmacist Nick Logan is eagerly awaiting the decision, and hopes the outcome will be based on evidence that shows pharmacists are capable of responsibly managing OTC codeine products.

“I feel very strongly about it. I think upscheduling is an illogical solution because, of the codeine-related deaths that are traceable, 60% of them involved codeine that was actually prescribed [by a doctor]. Also data from Medicare shows us that if a consumer is forced to see a GP for a codeine-containing analgesic they are likely to receive a higher strength and a higher quantity of tablets on prescription,” argues Logan.

“Accessibility should be a cornerstone when considering the supply of medicines for acute pain. Upscheduling these products would strip accessibility for acute pain and likely result in stockpiling prescribed medicine and a greater risk of misadventure.”

The Pharmacy Guild earlier this year set up MedsASSIST, its real-time recording system for codeine sales, to identify consumers at risk and refer them to doctors or support services.

Logan says real-time monitoring has shown itself to be an effective system.

“I was impressed at the speed at which the Pharmacy Guild of Australia responded to this problem with the delivery of MedsASSIST software,” he says.

“[My pharmacy] uses MedsASSIST for all OTC codeine analgesic sales as part of our store policy. It breaks down barriers and consumers enjoy the professional interaction. MedsASSIST gives us a chance to have really meaningful conversations with our customers about their pain, discuss management and refer if required.”

Since its national rollout in March, 65% of pharmacies are now taking part in MedsASSIST, with over 3.6 million transactions recorded.

In addition, 72,000 requests to purchase codeine medicines have so far been denied because of concerns about dependency issues, and 86% of consumers who made five or more purchases have been recommended to take follow-up action in managing pain and addiction.

There are some very clear steps the government can take to curb codeine misuse, says Logan.

“I believe that legislating the use of MedsASSIST nationally, reducing the pack sizes to a maximum of three days with very clear ‘Do not use for more than three days’ labelling is the answer to OTC codeine abuse. It might even provide an evolving, digital professional service that could attract federal government remuneration. The savings to the MBS would also be huge.”

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