Doctors attack Guild codeine proposal

Outspoken pharmacy critic Dr Edwin Kruys has taken aim at the Guild over its proposed model for codeine

Yesterday in Forefront, the Pharmacy Guild outlined its proposed “Prescription – except when” system, which would allow patients to access codeine preparations under certain limited circumstances through community pharmacy without a script.

It cited examples such as severe toothache where a dentist’s surgery is not open, after hours or in rural areas without services.

The Guild said pharmacy representatives have met State and Federal Ministers and politicians, as well as other stakeholders, to discuss the proposal.

Today, RACGP Queensland chair Dr Edwin Kruys took to Twitter to condemn the proposal.

Pharmacy stakeholders were quick to respond:

In mid-2016, a report by the National Drug and Alcohol Research Centre showed that prescription painkillers now account for 70% of accidental opioid deaths in Australia.

These included oxycodone, morphine, fentanyl and codeine.

The report showed that 564 Australians aged 15-54 died from accidental opioid overdose in 2012 – the latest year for which national coronial data was available.

Of these deaths 394 were due to pharmaceutical opioids such as oxycodone, codeine, morphine, fentanyl and methadone. While there was a slight dip in the number of deaths from 2011 to 2012, the report warned that projections suggest that the number of deaths due to prescription painkillers would further increase for 2013 and 2014.

The increase in opioid related deaths accompanied a significant increase in prescribing of opioid painkillers in Australia over the previous decade.

Dr Kruys continued to tweet on the subject, citing an AJP article on a Canadian paper as well as NPS MedicineWise data.

Dr Evan Ackermann, Chair of the RACGP Expert Committee Quality Care, also queried the initiative, challenging PSA national president Dr Shane Jackson over the matter.

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1 Comment

  1. Amandarose

    The discussion should be about opiate addiction and how to tackle it together. The reality is by just stopping OTC codeine it will not stop addiction but it will possibly reduce entry. I wonder what people will replace their addiction with? Cough syrup? Sedating antihistamines? Prescription analgesics? Alcohol? Street drugs?
    Will those with migraine and tension headache now suffer?
    It’s a difficult area. On one hand we all know many abuse codeine. The single biggest thing we did to reduce this where I work is Medassist. Unfortunately the majority of pharmacies in our area do nou use it due to profits which is so silly as if everyone embraced it we may have had a better case. We are lucky to sell 5 codeine products a day now and the majority of those are suggested by us. Compared to other pharmacies in the area who throw them to anyone who I know sell up to 1000 codeine products a month.
    I think it is important to identify and open a dialogue with addicts and discuss the reasons they take so much. If you are honest and non-judgmental you can really help people admit to a problem and receive help. I have sent a few patients to the local addiction doctor who has weaned them off with Suboxone.
    Another couple has serious pain that needed addressing- both autoimmune and both had not been to a doctor for diagnosis and referral. On steroids then Methotrexate their pain was addressed.

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