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Codeine Debate

Pain relievers to be Prescription only?

It is proposed that the current Schedule 3 codeine entry be rescheduled to Schedule 4, “due to potential issues of morbidity, toxicity and dependence”.


Patients using codeine-based painkillers or cough suppressants will soon need a prescription from their doctor, if the recommendations of an interim report are put in place.Consideration may be given as to whether all current Schedule 3 preparations should be rescheduled to Schedule 4, or whether any rescheduling to Schedule 4 should only apply to combination analgesic products containing codeine.Consideration may be given as to whether the Schedule 2 entry for codeine should also be amended.Other proposals include amendments to esomeprazole, hydrocortisone and hydroctorisone acetate, naloxone, and the rescheduling of orlistat from Schedule 3 to Schedule 2 for oral preparations for weight control purposes containing 120mg or less of orlistat per dosage unit.

The interim decision to reschedule codeine-containing medicines will have a major impact on consumers needing to purchase the products for legitimate health reasons, the Pharmaceutical Society of Australia says. Acting National President of PSA, Michelle Lynch, said the interim decision based on the recommendation of the Advisory Committee on Medicines Scheduling (ACMS) on the schedule of codeine is to delete the current Schedule 2 and 3 entries and to amend the current Schedule 4 and 8 entries to reflect this change, with a proposed implementation date of 1 June 2016.

 “This change will have an overwhelming impact on consumers, pharmacists, medical practitioners and industry given codeine is a widely used ingredient and contained in many over-the-counter medicines for pain management and treatment of coughs and colds,” Ms Lynch said. “There will be considerable impact on professional pharmacy practice and potentially changes to the education, support and management advice provided to patients and carers.    “While PSA is concerned with the rising levels of harm associated with the inappropriate use of codeine-containing analgesics, we have stressed that a holistic, multifaceted approach is necessary to achieve consumer-focussed outcomes.” Ms Lynch said that while a more restrictive schedule may, in the short term, lead to less codeine use, including misuse, it was unlikely to fundamentally address the underlying problems leading to misuse, nor provide a long-term health solution.