Clock ticking for over-the-counter codeine sales

From February 1, combination pain relief medicines that include codeine will only be available on prescription. Read the full media release.
With just three weeks to go before over-the-counter sales of codeine are banned Australia’s top pain medicine body is reminding patients there are alternative pain relief options.

From February 1, 2018 combination pain relief medicines that include codeine with brand names such as Panadeine, Nurofen Plus and Mersyndol will only be available on prescription.
The Dean of the Faculty of Pain Medicine (FPM) of the Australian and New Zealand College of Anaesthetists, Dr Chris Hayes, said it was important that patients talk to their GPs and pain physicians about how best to manage pain and how the new codeine restrictions may affect them.
“Most people will be able to manage their short-term pain with a range of other, over the counter medicines that don’t contain codeine,” he said.
“But if you’re at all unsure seek advice on what the most appropriate medicines and pain relief are best suited for you. There are many safer and more effective alternatives available that don’t have the harmful side effects of low-dose codeine.”
The combination of anti-inflammatory medication with paracetamol provides better pain relief for many types of acute pain without the risk of codeine addiction.
Dr Hayes said low-dose over-the-counter codeine, which is a weak opioid, has been found to be highly addictive. Nearly one in ten people are unable to metabolise codeine.
When codeine is combined with paracetamol or anti-inflammatory drugs overdose can lead to:
  • serious liver damage
  • stomach ulcerations
  • renal failure and even death.
Dr Hayes said many people may not be aware that codeine is closely related to morphine and is a derivative of opium poppies.
“Codeine should not be used to treat a migraine or period pain. There are significant costs to the patient, their families, public health resources and the community when patients become addicted to codeine,” he said.
“When exploring other alternative treatments it’s good to be aware that unlike codeine, paracetamol and ibuprofen are not opioids and not addictive.
“Pain relief isn’t just about medication. Self-managing your condition, including thinking well, eating well, keeping physically active and making sure you stay socially connected with friends and family can change the way the nervous system responds.”
Alternative pain relief strategies can include:
  • Gentle exercise.
  • Meditation.
  • Acupuncture.
  • Massage therapy.

FPM was one of several organisations that made submissions to the Therapeutic Goods Administration (TGA) inquiry into codeine over-the-counter sales.

FPM argued that the widespread availability of codeine in pharmacies was a serious public health concern, with rising numbers of people misusing the drug. FPM had urged the removal of codeine from a schedule 3 classification – where it can be sold over-the-counter in pharmacies – to schedule 4, where it can only be supplied with a doctor’s prescription.

More than 25 countries including the US, Japan, France and Hong Kong have made codeine a prescription only medicine.
Copyright © Australian and New Zealand College of Anaesthetists.