Aussies are taking too many analgesics and a third have mixed them with alcohol, new data from NPS MedicineWise shows

Ahead of next week’s Be MedicineWise Week (August 21-27), NPS MedicineWise gathered data on Australians’ use of painkillers and found that 12% had exceeded the recommended daily dose.

More than a million—6%—had taken nine or more paracetamol/codeine tablets in a day at least once, while another 1.2 million—9%—had at least once taken seven or more ibuprofen/codeine tablets in a day.

And Millennials are twice as likely as Baby Boomers to have over-used ibuprofen/codeine combinations.

“It may be that Baby Boomers are mostly taking medicines regularly, including pain medicines, so maybe they’re a bit more in tune with how to take them and have a better relationship with their pharmacist and GP,” said Lynn Weekes, CEO of NPS MedicineWise.

“So it could be that they’re more confident following the instructions, or maybe it’s just less risk-taking behaviour in that age group.

“Millennials are a group of people we don’t often think of as high-risk, so it’s an interesting finding for pharmacists and they could think about the 30-year-old coming in for pain medicines as well as the older people.”

Millennials were also much more likely to have over-used Codral Cold and Flu Tablets, the research found; around half a million Australians had exceeded the recommended daily dose of these as well.

Dr Weekes says that the data showed 1% of people had taken 16 or more paracetamol/codeine tablets in one day at some point in their lives, and another 2% had taken 13 to 15 tablets.

She urged pharmacists to talk to people presenting for codeine combinations – whether they’re concerned about misuse or not – to talk to their doctor or consider alternative therapies before 1 February 2018.

“Given we know codeine’s about to be rescheduled, we’re really encouraging pharmacists to work with people now,” Dr Weekes told the AJP.

“If they’ve been using a lot of Mersyndol or ibuprofen/codeine lately, maybe refer them to their GP as there might be some CBT or some physiotherapy appropriate as well, and shifting to another alternative such as the paracetamol/ibuprofen alternative which should work better than the codeine product.

“The data does look good for those products and they’re unlikely to cause dependence, but if a dependence is psychological or if their pain’s not being managed, you might still find someone taking very large amounts of it.”

She warned that many consumers don’t see paracetamol or ibuprofen as dangerous, and so will still need counselling to help avoid using too much of the product.

A pharmacist wrote on AJP’s Facebook page recently that a patient reported finishing a box of 12 paracetamol/ibuprofen combination in one day, “because they were told to take it without any further instruction,” for example.

“People assume that because something is OTC, it’s safe and that you can take it however you like,” she says.

“But iburprofen, paracetamol and aspirin can all cause serious side-effects, especially paracetamol as at high dose it’s very toxic – so there’s a real place for pharmacists to give advice on these medicines too.”

Drugs and alcohol

Also covered in the NPS MedicineWise research was the extent to which consumers mix medicines, including those which contain codeine, with alcohol.

Thirty per cent had consumed alcohol soon after taking prescription pain relief medication.

This was most likely to occur when someone is out enjoying themselves and doesn’t want pain to spoil their night (19%).

“Thirteen per cent of people said they will take pain relief at the beginning of the night as a precautionary measure so they wouldn’t get a hangover later on,” Dr Weekes says. “It’s an interesting idea.”

“There’s a real message we need to send about ‘don’t take alcohol with this’,” she says. “It’s not really something we talk about with OTC pain relief, really, but pharmacists can advise people that if they’re going out, to take the medicine at least a couple of hours beforehand so that it gives it a chance to work and they’ll feel better before they go.

“They also need to be made aware that the alcohol is more likely to sedate.”

As many as half a million Australians had taken prescription painkillers and then consumed alcohol for the “buzz”.

More than 3 million Australians (17%) have some experience of physical dependency on medication, either because they became dependent themselves or through someone they know.