Codeine decision an opportunity as most take up MedsASSIST

white pills - look like codeine combination OTCs

The TGA’s long-awaited decision on the scheduling future of currently-OTC codeine-containing medicines – whatever that decision may be – will be an opportunity for pharmacy, says a pain expert.

Joyce McSwan, clinical pharmacist, pain educator and Persistent Pain Program manager at the Gold Coast Primary Health Network, told the PSA16 conference that pharmacy is not entirely up-to-date with developments in the use of codeine-containing medicines.

“The October interim recommendation on codeine rescheduling was on the back of data revealing significant risks from the use of codeine-containing products for treating pain,” she told the conference.

“But from a pharmacy perspective, any decision that does eventuate should spell opportunity rather than rattle the system.”

However, she said it must be acknowledged that a lot of recent research questions the sustaining of codeine as a non-prescription analgesic.

“As a profession we need to keep up to date with the latest research in this field,” she says.

“I think our profession is not entirely on top of the shift in the usage of codeine.

“Deaths have increased relating to its use, hence the need for the TGA to respond. It’s a weak analgesic for immediate through acute pain of mild to moderate pain intensity.”

She praised the Guild’s launch of MedsASSIST as “really an excellent tool, and I urge all pharmacies to sign up to it”.

There was some uncertainty as to the number of pharmacies signed up to the program – McSwan cited a figure of 1500, while the Guild today confirmed that the true figure is now approximately 3500.

A spokesperson for the Guild told the AJP today that MedsASSIST is increasingly helping to identify patients at risk of inappropriate use of over-the-counter medicines containing codeine and urged all pharmacies to be part of the program. 

“The ultimate success of the program in supporting our case against the upscheduling of these medicines to prescription only lies in its maximum possible uptake by pharmacies across the whole country,” the spokesperson says.

“We need to have every pharmacy in the country using MedsASSIST to monitor the use of these products. So far we have more than 60% of the community pharmacies in Australia have used the MedsASSIST program and the number is growing.”

The spokesperson says the Guild aims to see State and Territory Medicines and Poisons regulations amended to mandate the real-time online recording of codeine supply.

“Until then MedsASSIST requires informed patient consent and pharmacies should follow the approach outlined in the reference guide resources available on the MedsASSIST portal.”

The spokesperson said the program is helping to open dialogue between pharmacists and patients.

“Some patients are apprehensive about this new approach but the majority understand the reason for the system’s introduction and the need for pharmacists to determine therapeutic need.”

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1 Comment

  1. Daniel Roitman

    While MedsASSIST is certainly a step in the right direction, it is not without it’s flaws. Some of you may have noticed that the program does not link the driver’s licence, passport and/or keypass of an individual. Therefore, if that individual has all three, or more, forms of identification, they can easily access codeine products at three times the rate that is intended. Some “problem” customers have already figured out this gap in the system and are attempting to exploit it. Largely, it is in this cohort that we are trying to limit use of codeine products; if this cohort has already identified a loophole then the work of MedsASSIST has been jeopardised.

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