Australian pharmacists were banned from selling over-the-counter codeine medication to people without a prescription in February last year, meaning patients now require a note from the doctor to obtain pain-relief medication including Codral, Mersyndol, Panadeine and Nurofen Plus.
At the time, The Therapeutic Goods Administration (TGA) claimed alternative over-the-counter painkillers were just as effective for short-term pain as low-dose codeine products, but without the codeine-related health risks.
Now new data released by the TGA shows 17.1 million packs of codeine-containing products were sold in 2018, approximately 50 per cent lower than the yearly average of 34.7 million for the previous four years.
The AMA said the results prove the ban was the right decision to reduce the number of “addictive” and “harmful” codeine products dispensed in Australia. Thousands of Australians were misusing the products and putting themselves at risk of addiction, organ damage and other serious health problems.
Codeine is an opioid drug closely related to morphine and is derived from opium poppies. It can cause opioid tolerance, dependence, toxicity and in higher doses, death.
It can also cause mild symptoms such as dizziness, tiredness, rashes, stomach ache, as well as more serious issues such as breathing difficulty, hallucinations and even comas.
A previous study found that deaths where codeine was determined to be an underlying cause more than doubled from 3.5 million to 8.7 million over the decade from 2000 to 2009. Another 2017 analysis of records from a 600-bed Australian hospital between 2010 and 2015 also found 99 admissions were the result of over-the-counter codeine misuse, costing the local healthcare system around $1 million.
“The evidence shows that low-dose codeine provides little benefit beyond placebo for short-term pain and it is not a safe treatment for long-term or chronic pain,” AMA President Dr Tony Bartone said in a statement. “The AMA strongly supported the decision by the TGA, as the independent regulator, to act in the interests of patient safety, and up-schedule codeine products.”
The decision to ban over-the-counter sales of codeine was met with criticism from many in Australia including chronic pain sufferers and pharmacy lobby groups, who believed the ban would lead to doctor shopping and patients switching from low-dose to high-dose codeine medicines to manage pain.
“However, the TGA analysis shows that the increase in the supply of high-strength 30mg codeine between February and December 2018 was not statistically significant,” Bartone said. “These reforms have always been about reducing the level of codeine in the community, not about switching the source of the supply of codeine.”
The TGA analysis estimates that around 6959kg less of codeine was supplied to patients in the 11 months following the ban.
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