Most people should be able to manage their pain with safer alternative medicines, says TGA
The consumer fact sheet called Codeine-containing medicines: Harms and changes to patient access outlines the changes that will occur from 1 February 2018, when codeine products go prescription-only.
“Most Australians are unaware that over-the-counter medicines containing codeine for pain relief offer very little additional benefit when compared with medicines without codeine. The use of such medicines however, is associated with high health risks, such as developing tolerance or physical dependence on codeine,” states the TGA in its fact sheet.
“Pharmacists have an important role to play in minimising harm from codeine,” it says, adding that they will be an important source of information and advice for consumers both before and after the scheduling change.
“Your pharmacist will be able to help you choose from a range of effective products that do not require a prescription,” it continues.
“Most people should be able to manage acute pain or cough and cold symptoms with safer alternative medicines.
“For acute pain, this may include products containing paracetamol or ibuprofen, or the two products in combination. Your pharmacist will be able to provide advice on the most appropriate medicines for you.”
Some AJP readers have expressed concerns that they will be unable to offer an effective OTC alternative.
“The only way to really fix this is to have an alternative to codeine come off S4 to S3, as many people cannot use an anti-inflammatory,” says one reader.
“Patients currently laugh at me when I recommend paracetamol… what is it going to be like when we have no other options?”
Most AJP readers have also shared their concerns that patients will turn to stronger alternatives or stronger doses of codeine from their prescriber.
“Every time access to a ‘recreational’ substance has been impaired it has caused a flood of users to other more harmful options. Every time, without fail,” says reader Andrew.
“A huge cohort of undertreated pain and opioid-loving patients will be scratching around for an alternative.”
However the fact sheet suggests that patients with ongoing pain should look to better alternative treatment options.
“People with ongoing pain should talk to their doctor or healthcare provider to determine better alternative treatment options. These may include: alternative over-the-counter or prescription medicines; non-medicine therapies from an allied health professional such as a physiotherapist; self-management tools such as exercise or relaxation; or referral to a pain specialist or pain management clinic,” it says.
The TGA reassures pharmacists that advice regarding the changes to codeine access, to help them provide the best advice to their patients, will be made available on the Health Department’s website closer to the schedule change date.