Codeine: it’s now up to the states

The Pharmacy Guild has reversed its position on the codeine upschedule – or so says the Health Minister

Speaking at the Royal Australian College of General Practitioners’ conference in Sydney on Friday, Greg Hunt said that “the Guild has reversed its position and has accepted the upscheduling in full,” the Sydney Morning Herald reports.

“So they’re not the only ones that can be strong. On this, they have now come around and made it absolutely clear that they will work us and support the upscheduling,” the Minister reportedly told the conference.

“The final implementation of this scheduling is a matter for each State and Territory as to whether they adopt the decision in their own jurisdiction,” Mr Hunt said.

A spokesperson for the Pharmacy Guild told the AJP today that the organisation was not seeking to reverse the TGA decision to upschedule codeine.

“However we have put forward a proposal to the States and Territories, which have responsibility for the drugs and poisons schedules in their jurisdictions, for a confined exception for acute pain only under a strict patient protocol with mandatory real time monitoring,” the spokesperson says.

“We have done this because we believe it is a common sense approach to address the issues of maintaining convenient access where appropriate for legitimate users and identifying at-risk patients given there is no real time monitoring at the prescription level.

“At this stage no State has accepted our proposal.

“The Guild is committed to making sure that the upscheduling is as smooth as possible for affected patients and that pharmacies are supported in their central role in enabling this transition.

“With three months until the up-scheduling occurs, it is important that pharmacists are discussing the codeine up-scheduling with their patients and helping them prepare for it.  

“The Guild and the PSA are developing a comprehensive package of training and information materials to enable all community pharmacies to assist patients with this transition.”

Mr Hunt announced at the conference that the Turnbull Government was providing more than $1 million “$1 million to ensure health practitioners and consumers are informed about changes to accessing codeine-containing medicines”.

“I have listened carefully to calls from State Health Ministers, consumer and medical groups for more support and this funding announced today will ensure health professionals and consumers have the information they need,” he said.

“Over-the-counter codeine products have been estimated to be a factor in nearly 100 deaths each year, with evidence that three in four pain-killer misusers had misused an over-the-counter codeine product in the last 12 months.

“These changes are also in-line with international practice, with at least 26 countries only allowing prescription access to codeine based products.”

Mr Hunt thanked stakeholders including the Pharmacy Guild and the PSA, “for their commitment to working with their members to assist patients during this transition”.

The speech followed reports that fellow Liberal politicians had told Mr Hunt in a party room meeting that the upschedule was “unpopular with constituents and would not work”.

Before this, State and Territory Health Ministers had written to Mr Hunt urging the Federal Government to ensure the implementation of the upschedule was better managed.

RACGP president Dr Bastian Seidel said on Friday that there would be no “tsunami” of patients going to see their GP for prescription codeine after 1 February 2018.

“What we will see is a shift to safer, more effective pain relief,” Dr Seidel said.

However this contradicts Guild figures released in August which showed 72% of consumers would most likely visit a GP for codeine-containing analgesics post-upschedule.

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