Tasmanians to track low-dose codeine


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Tasmania is leading the way as it sets up real time monitoring of formerly-OTC codeine, pharmacy stakeholders say

The island state has announced that it plans to implement Drugs and Poisons Information System Online Remote Access (DORA) for a number of Prescription Only drugs of concern, in addition to the Schedule 8 drugs it already tracks.

PSA president Dr Shane Jackson told the AJP that Tasmania has been “well ahead” on real time monitoring for some years.

“Essentially what they’ve done now is what they said they were going to do from the middle of last year, so it’s not just codeine, it’s other high-risk drugs: benzodiazepines, Tramadol and so on,” he says.

“Codeine will be part of that. So they’re making sure they have the information in real time, not just for S8s but other opioids and high-risk drugs, so pharmacist and doctors will have access to that and Tasmania has led the way here.

“One of the reservations some sectors had around the [low-dose codeine] upschedule was the loss of visibility. But in Tasmania we’ve got a full, complete picture which is excellent, and we welcome that.”

Pharmacy Guild Tasmanian branch president John Dowling said that DORA works “really well” in Tasmania, but hopes for a national system to be set up.

Health Minister Greg Hunt told the PSA17 conference last July that a national real-time monitoring system was to be rolled out but did not mention low-dose codeine.

“DORA works well because we’re a very small jurisdiction, and it’s a fairly manual system,” Mr Dowling says.

“It’s been offered to the larger jurisdictions but the cost of running seems too high. The one the Victorians are doing, hooked up with eRx, is more of an electronic system and we support that being rolled out throughout the country – that’s the Guild’s preferred option.

“I can’t see Tasmania switching over in a hurry, but I think eventually we’ll end up with a national system.”

The ACT also recently announced that it will use DORA to track S8s and potentially some S4 drugs.

“We support DORA covering codeine because from the Guild’s point of view, at least with MedsASSIST we had something nationwide that could monitor codeine prescriptions – whereas now, people in any other jurisdiction apart from Tasmania could be doctor shopping for codeine and you can’t pick it up,” Mr Dowling says.

“So in Tasmania, DORA should minimise the problem of people doctor shopping for codeine. But the Guild supports a national real time monitoring solution and not different things in different states.”

Dr Jackson also underlined the importance of a national solution.

“We need to make sure we have interoperability,” he says. “If there’s a different system in Tasmania and a different system in Victoria, what’s going to be the way of linking up those systems?

“They need to be interoperable. We need to make sure the states are talking to each other.”

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1 Comment

  1. Sam0077
    04/07/2018

    The PBS recommend folk to use NASID pain killers which I for one am allergic too. All based on Aspirin mostly or paracetamol which The British Lancet said early this Century that it was useless for pain other than a mild headache and also dangerous as often ill used.. More than 8 mg a day of paracetamol starts to kill your liver. I knew of a girl I worked with who threw 4 a time down her throat in spite of warnings on packets and verbal. I wonder now if she is still in good health.

    I was on 240 Panadeine Forte plus 120 codeine 30 mg tabs a month. Now my doctor will only give me the choice between the two, I chose the plain 30 mg tabs because I loath the risk of paracetamol and am finding not enough.- I used the 4 plain tabs during the night – and the others during the day as wrote down times. Prior had been ;put on Fentanyl, Lyrica,and several others that had rotten side effects.
    I did do Norspan patches with 240 prior Forte for 18 months but the patches then started to make a rash so stopped them. And that’s when added the extra 4 x 30 mg for night use. I also was put on Oxycodone but being on time release – did not much for me again. I am a fast metaboliser. ie 2 hour local at the dentist lasts 20 minutes and 4 hour 40. But GP’s disbelieve me. Dentists dont as it was a dentist who first alerted me to why I was hating the dentist – with having injection on top of injection to stop me squirming whilst they worked on my teeth due to pain.

    I now have to go back and tell my GP that 4 tabs of 30 mg isn’t enough, I am waiting on a knee replacement after having waited for years for hip replacement which was first pain of any magnitude and for a while didn’t need hardly any tabs at all -but the knee is really so bad can hardly walk without some relief, cant even walk without a walker now.
    What I would like to see is not attacking innocents in seek of pain relief but going for those on so called recreational drugs which I am sure kill more than 100 a year attributed to Codeine med’s.

    For years western world and Australia has been soft on these illegal drugs – but OK for cannabis for small own use. Well these OTC and prescription for larger amounts are legal.
    Yet its always the legal who get legislated against whilst the criminals get away with it time and again and you cant bet that more than 100 die a year on illegal drugs. But no one surveys those.

    And isnt it strange that on the day that you cannot buy OTC pain tabs out came huge posters on counters in pharmacies to buy Maxigesic. Which is far worse than Codeine as strangely the AMA on Ibuprofen have been saying for years.

    But now silent as many more patients in surgery for a script for what once was OTC and how much extra will this cost the health budget? The cost of a GP visit is enough to send that bit up by millions and because lack of doctors, its hard to get in to see one now have to wait up to 2 weeks.

    And GP’s are scared of losing their licence to practice but also for years we have heard rumors of a GP billing 100 patients in a day etc. But not news of being charged with ripping off the system as even with the 10 mins booking – no normal day can one GP service 100.

    As for the bit about chronic pain – most those saying Codeine not good enough for this, go use an OTC NASID – are simply doing the same job as they did on generics – whom the pharmacists did get paid more for as Tony Abbot said in Dec 2016 media release – and probably still do as they trot out -these are exactly the same.
    Lies. Because the only thing the same is the active ingredient and that can be between 80-120% equivalent to that used in original drug trialled on human beings for years before release.
    So as money is the driver of these – 80% is most likely so weaker than originals. Also my own experience of antibiotics – they are weak and dont work. As infection comes back later on – and most wont notice and go back again – my doctor did asked me for box and when he saw it – said blooming generics !
    Today unless one makes the pharmacist aware you wont take a generic, they simply put them in the bag so you have to check in a strange pharmacy. so must get more payment or still wouldn’t be pushing them. As I found the other day getting a script filled.. 2 of 3 items were generic – gave me the bag and I opened it to check luckily, as saved me return visit and got the real thing tested on human beings not one tested randomly and never on humans before being release on onto the public – wonder who got the kickback on that eh? Cynical yes very but all too often correct.

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