In late 2016 the Therapeutic Goods Administration (TGA) made the decision to make products containing codeine no longer available over the counter at pharmacies, making them prescription only medicines. This decision comes in effect on February 1st 2018.
The TGA stated that they considered compelling evidence of the harm caused by the overuse of over the counter codeine as primary reason for this decision. Additionally the USA, most of Europe, Hong Kong, Japan, the United Arab Emirates and several other countries have already stopped codeine-containing products from being sold without prescription.
The TGA also considered that low dose codeine-containing medicines are not intended to treat long term conditions, with public consultation indicating that many people use these products to self-treat chronic pain and were becoming dependent on codeine.
The TGA decision maker also took into account that there is little evidence that low-dose codeine medicines are any more effective for pain relief or cough than similar medicines without codeine.
There are differing opinions on benefits and challenges associated with this change, referred to as upscheduling. The Pharmacy Guild of Australia for example have stated that making codeine prescription only will increase doctor shopping and sees the upscheduling as unnecessary. Many pharmacies already have a monitoring system in place which has seen a drop in use.
Positive Life NSW has raised the issue that, as empowered patients, people living with HIV will now face an environment where extra negotiation and appointments with doctors will be needed. They also note that the alternative option to over the counter codeine preparations such as paracetamol/ibuprofen are impractical as many people living with HIV who are on anti-retroviral medications will need to consider drug interactions and have increased risk of renal, liver or kidney damage.
Regardless of the views on the upscheduling, the reality is that from the 1st February the days of popping in to your local pharmacy for a box of Mersyndol or Nurofen Plus will be over, unless you have a prescription. So be prepared. If you use these drugs regularly see your doctor/ GP so that you can discuss what the changes mean for you and that are not left without and face unwanted withdrawal symptoms.
For more information on the changes, check out the following resources:
- Codeine facts – DrugInfo
- Codeine Information Hub – Therapeutic Goods Administration
- Countdown to codeine changes – North Western Melbourne Primary Health Network
- Codeine rescheduling FAQ – NPS Medicinewise
- Codeine: Community toolkit – Scriptwise
- Media release – Positive life
If you’d like to discuss the changes to codeine access further, you can contact ACON’s Alcohol and Other Drug team on (02) 9206 2067.