Upscheduling codeine-containing preparations to script only is unlikely to address issues of misuse and abuse, stakeholders say
A spokesperson for the Pharmacy Guild told the AJP today that the TGA’s decision to upschedule the medicines from 1 February 2018 will disadvantage many people who currently use them appropriately.
“The demand for codeine products will remain, and there is no evidence that making codeine products prescription-only will reduce demand or abuse,” the spokesperson says.
“This is not about loss of money for pharmacy, rather this is a public health issue and anyone thinking it will reduce abuse hasn’t been listening to newspaper reports or coroner’s reports.”
The Alcohol and Drug Foundation said today that making codeine prescription-only does not negate the risk of harm – more Australians are dying from pharmaceutical overdoses than all illicit drugs combined.
ADF National Program Manager Julie Rae told the AJP that the upscheduling news provides an opportunity to educate not only consumers, but also health professionals about the harms of abusing, misusing or simply overusing codeine-containing painkillers.
“This isn’t only about doctor-shopping, but about accidental overuse,” Rae says. “There are people legitimately using codeine, but they’re overusing it, and we have to have conversations with them.
“We know people are taking codeine for pain, but some are also taking it for other ailments, such as stress, anxiety and also insomnia. We need to start looking at what’s causing these people to take these painkillers.”
Rae says she hopes that GPs will take the opportunity to investigate these issues rather than simply prescribe.
She also called for a real-time prescription monitoring system to be rolled out nationwide.
“We support what the Pharmacy Guild has been doing in terms of MedsASSIST and recording, as well,” Rae told the AJP. “These are all things which can help. But we also need to ensure that these issues are raised with both doctors and pharmacists.
“There need to be further exploratory conversations with GPs and pharmacists about getting people into help when they’re at a stage when they’re becoming dependent on the drugs.
“The real concern for us is not whether codeine is OTC or prescription, but the fact that we have a drug that causes instant relief, that’s causing great harm – and so this is about raising awareness of safe practices in medicine and safe use of medicines.”
A silly decision
Pharmacy Guild national president George Tambassis told Today’s Lisa Wilkinson this morning that without a real-time prescription monitoring program, the upscheduling decision will not address the problem.
“We think it’s a silly decision, Lisa,” he told her.
“The Government is now saying—or the TGA is saying: let’s up-schedule these medicines to a prescription-only system.
“There is no real-time monitoring system under prescription-only, doctors haven’t got any access to other doctor surgeries. We believe a real-time monitoring system is the only way to go with these medicines.”
He cited MedsASSIST data which showed 98% of Australians were using codeine-containing Pharmacy Only and Pharmacist Only medicines as intended.
“Less than 2% have been picked up as patients that potentially are addicted and every single one of those patients has been referred to more care.
“We do believe that in some cases you can get addicted to these medicines, we certainly don’t want any deaths from these medicines, but the overwhelming majority of people in Australia use these medicines safely.”
The onus is now on the Government to explain why codeine-containing preparations become more expensive, and why the overall cost to the health system will rise.
“Because you have to line up in doctor’s surgeries to get access to these medicines. We’re talking about over 25 different products that you can buy over-the-counter right now are going to go up in price.
“And it’s going to be a bigger burden on the health care system if this thing goes through.
“I’m hoping this decision won’t go through because we’ve been advocating against this decision for over a year.”