Rules around pharmacist vaccinations differ between states – and the same could happen for codeine availability, one stakeholder says

With only two days to go before low-dose codeine is upscheduled to Prescription Only, the University of Sydney’s Professor Peter Carroll has written to the NSW Health Minister, Brad Hazzard, to explain how NSW could go it alone on codeine.

Prof Carroll highlighted an interview Mr Hazzard gave to 2GB’s Ben Fordham last week, in which the Minister suggested NSW could not make its own decision on codeine’s availability, as consistency between states was necessary.

But the precedent already exists with vaccination, Prof Carroll says.

“Vaccines are Schedule 4 prescription only medicines in all states,” he wrote to the Minister.

“However, Jillian Skinner as Health Minister regulated in NSW that influenza vaccine can be administered to patients by approved pharmacists without a prescription under approved protocols and conditions.  

“In the ACT the Health Minister has regulated that diphtheria, tetanus and pertussis vaccine, as well as influenza vaccine can be administered to patients by approved pharmacists without a prescription under approved protocols and conditions.”

Meanwhile in Queensland, regulations allow the measles, mumps and rubella vaccine, diphtheria, tetanus and pertussis vaccine, and influenza vaccine to be administered to patients by approved pharmacists without a prescription under approved protocols and conditions.

“This means that an approved pharmacist working in Tweed Heads can only administer to people in NSW influenza vaccine without a prescription, but if that pharmacist walks across the border and works in Coolangatta they can then administer without a prescription to people in Queensland measles, mumps and rubella vaccine, diphtheria, tetanus and pertussis vaccine, as well as influenza vaccine,” Prof Carroll wrote.

This highlights that there is already “clearly no consistency” between states regarding certain medications, he says.

“On, or before February 1st you as NSW Health Minister, or any other State Health Minister for that matter, could regulate to mandate real time monitoring of the supply of low dose codeine-containing products in all pharmacies, and allow pharmacists to supply low dose codeine-containing products (up to 3 days’ supply) without a prescription for the treatment of acute, short term pain,” he advises the Minister.

“It would be identical to the situation that currently exists for vaccines.”

If the Minister made this call, it would not be possible for Australians living outside NSW to continually cross state borders in search of codeine, due to the requirement to show ID and be subject to real-time monitoring, Prof Carroll says.

Such suggestions have been made, but are “nonsense,” he wrote.

“It wouldn’t matter where you lived, you would still only get one packet.”

He requested that the Minister make the call for NSW to go its own way on codeine, “in the interests of the hundreds of thousands of people in NSW who use these products safely and appropriately for the short term treatment of acute pain such as migraine, toothache and period pain”.

“NSW can go it alone.”