Guild predicted codeine outcome: Heffernan

codeine tabsules spill from orange pill bottle

Pharmacy Guild NSW president David Heffernan claims there may have been a “reframing of the truth” around the codeine upscheduling

In his President’s Address in the latest NSW Guild newsletter, Mr Heffernan writes that he found a recent special ABC report “fascinating”.

The report concerned research reported on in March by the AJP, in which Associate Professor Suzanne Nielsen, Deputy Director of the Monash Addiction Research Centre at Monash University, found that there was no evidence of increased codeine prescribing or increased prescribing of S4 or S8 opioids following the 1 February 2018 upschedule of low-dose codeine.

A/Prof Nielsen presented the data at the International Medicine in Addiction Conference in Melbourne in March and also appeared on an episode of the ABC’s 7.30 Report, where she discussed the issue.

She later told the AJP that opioid use in Australia was now “trending down” and “seemed to have turned a corner”.

The codeine upschedule did not explain all of this reduction, but was a part of the puzzle.

Her findings were questioned at the time by Anthony Tassone, the Guild’s Victorian branch president, said PBS dispensing data showed an increase in the number of scripts for 30mg codeine since the upschedule.

Now, Mr Heffernan writes that “Fact, the codeine upscheduling decision has delivered, as we predicted, an increase in higher dose prescriptions (11% in 12 months) according to PBS data”.

“In other words, 11% increase in PBS scripts only, excluding private scripts, for higher dose codeine has occurred since the upscheduling from February 18.

“This includes the months of reported stockpiling. Further, if one was to track PBS data on 30mg dose codeine over the last five years, they will find prescriptions for 30mg PBS codeine containing prescriptions were tracking down, further emphasising the impact of the re-scheduling.

“There appears to be a reframing of the truth around the codeine upscheduling.”

Mr Heffernan writes that “regardless of the spin,” the increased prescribing of 30mg codeine underlines the urgent need for a real time monitoring system in NSW.

“The Victorian experience has been an outright success and is being rolled out across the state this month,” he writes.

“The Branch will continue its advocacy of a RTPM as the vital tool in addressing the looming opioid crisis.”

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