Five top codeine questions revealed


NPS MedicineWise has highlighted the five most common questions about the codeine upschedule – and released resources for non-English speaking patients

Ahead of the impending upschedule to prescription only of low-dose codeine-containing preparations, NPS has compiled and provided answers to the most common questions about the change.

“It’s understandable that some people, particularly those managing chronic pain, are concerned about all codeine-containing medicines moving to prescription only,” says NPS MedicineWise spokesperson Sarah Spagnardi.

“We are ensuring people have access to evidence-based and quality information during this transition.

“Some people may be unaware that extended use of codeine or increasing their doses could harm them, and there are too many cases of everyday Australians finding themselves in difficulty.”

The top five questions are:

  1. Why is access to low-dose codeine-containing medicines changing? NPS MedicineWise answers this question by highlighting the issue of misuse and dependence and this risk compared to benefits of the products’ use.
  2. What about the people who can’t afford the time or money to see a doctor to treat their pain? NPS MedicineWise has advised consumers that pharmacists can advise about suitable OTC treatments “that can be just as effective as those containing low-dose codeine” for acute pain. It also advises consumers to visit a doctor or allied health professional, such as a physiotherapist, to discuss longer-term or more severe pain. “In the long run, this approach should save the patient paying for ineffective or harmful dosages of codeine,” it advises.
  3. Why is everyone being penalised for a small minority who abuse these drugs? NPS MedicineWise advises that the change will reduce people self-medicating with codeine and protects others from future harm.
  4. If codeine is so dangerous, why is it still available on prescription? “With codeine restricted to prescription-only, and requiring a visit to the doctor, patients and doctors can agree on pain management plans and follow-up,” NPS MedicineWise advises consumers. “This has the potential to reduce the chance of people developing problems that can arise from self-medicating with codeine-based medicines, such as dependence and other serious side effects.”
  5. People suffering stomach issues can’t take NSAIDs, meaning the only option for these will be paracetamol – are there any other alternatives? NPS MedicineWise advises that paracetamol is an effective pain relieve for mild to moderate pain, and that the low dose of codeine in currently-OTC preparations may not offer benefit compared to paracetamol alone. It encourages consumers to consider non-pill options, such as heat, cold or topical NSAIDs, and to consider discussing these with pharmacists or other health providers.

Meanwhile, NPS MedicineWise has also prepared foreign language fact sheets to help prescribers, pharmacists and nurse practitioners clarify the upcoming change to non-English speaking patients.

Languages included in the resources are Arabic, Simplified Chinese, Traditional Chinese, French, Greek, Hindi, Italian, Korean and Spanish.

The resources were developed for culturally and linguistically diverse (CALD) communities on behalf of the Department of Health and the TGA.

“Some people in CALD communities may be unaware that extended use of codeine or increasing their doses could harm them,” warns NPS MedicineWise spokesperson Kerren Hosking.

“There are too many cases of everyday Australians finding themselves in difficulty with these medicines.

“These factsheets simply explain why codeine is restricted to prescription-only — requiring a visit to the doctor — and people who’ve been relying on these medicines to treat ongoing pain can work with their doctor or health professional to develop more effective pain management plans and follow-up.”

The factsheets are available here.

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