Australian Chief Medical Officer confirms strong basis for codeine up-scheduling

Amanda Lyons

12/01/2018 1:53:36 PM

Codeine is no better for pain relief than other over-the-counter medications, Australia’s Chief Medical Officer Professor Brendan Murphy said.

Professor Brendan Murphy believes the decision to up-schedule codeine is ‘about saving lives’. Image: AAP
Professor Brendan Murphy believes the decision to up-schedule codeine is ‘about saving lives’. Image: AAP

Evidence shows codeine is largely ineffective for most pain relief, while contributing to significant overuse harms in Australia. Professor Murphy stands strongly by the Therapeutic Goods Administration’s (TGA) decision to up-schedule codeine from 1 February.
‘This decision is about saving lives,’ Professor Murphy said.
Professor Murphy emphasised that the TGA decision was made in line with the best medical advice and research, including strong evidence that codeine is no more effective for most pain relief problems than alternative options such as paracetamol and anti-inflammatory medications.
‘There are numerous studies that show codeine is not the miracle pain relief drug people think it is and there is compelling evidence of harm caused by overuse and abuse of over-the-counter codeine-containing medicines,’ he said.
Professor Murphy recommends patients affected by the up-scheduling visit their GP to access more effective methods of pain relief and to seek assistance for codeine dependency if necessary.
Dr Milana Votrubec, GP and Chair of the RACGP Pain Management Specific Interests network, agrees with this recommendation. She views the up-scheduling as a chance for people experiencing issues of dependence to get the more holistic help they need.
‘I think it’s a great opportunity for GPs to address problems that have been running under the radar out there in the community,’ Dr Votrubec told newsGP. ‘[The codeine up-scheduling] is basically trying to help people who are doing harm to themselves.’

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Judy smith   12/01/2018 3:12:33 PM

Even if it is the right decision I think the implementation has left a lot to be desired. Patients have not been taken on the journey. Yet again we have had the medicinal profession saying we are doctors we know what it right for you. Many patients have already employed their pain management in conjunction with their GP and have been advised to take codiene. Many people can’t take anti inflammatory medications Many people don’t have a GP 75 year olds are being treated like drug addicts There has not been a huge increase in community based pain clinics and consumers are the ones who are left to try and navigate this mess and all many of them want is some relief from their chronic pain

Mai Maddisson   16/01/2018 6:04:37 PM

Codeine may not be a useful pain relieving medication: But who defines what pain is! The substance is being sought out above other substances . It must be doing something. What is that something? Maybe we should address that question first. Maybe it is the emotional pain which is intolerable and muting it with the codeine allows a person to get on with their day.
Maybe at times the devil we know if preferable to the one we don't and which will inevitably be sought out.
The youngies are mobile enough to access some other panacea. We need to know what their pain is. The opiates of which codeine is a derivative have been known to mankind for a long time and yes the person accessing them will weigh out the pros and cons of the 'pain relief' obtained.
The older patients go to GPs moderately frequently for other ailments: If their GP is the 7 minute variety and wears a new mask each time the patient appears, the former is not likely to notice a change in a patient: That they have become more distressed, perhaps limping more, perhaps dopey because they can't sleep. One cannot compare unless one generates opportunities to do so. I certainly would not share any personal problem with a total stranger, or an acquaintance.
Then we niggle at the burgeoning health budget: Will it tolerate the added visits to a GP for those small packs of what ever. Some incriminate the included paracetamol as being the devil: Why not take it out. Codeine was available in the past sans the paracetamol.
We seem to be spending an awful lot of money and resources chasing the devils we know. And maybe the elderly don't care about the long term sequels: Maybe they don't even want to visit strangers who call themselves GPs every time they have done a bit of atypical gardening exercise.
Maybe we ought start exploring what the alternatives are out there for people who seek out codeine containing medication: Maybe their long term negative sequels will far outweigh the codeine induced ones.
I guess the liquor shops are accessible to all above 18. Maybe the nearest one is far closer and more accessible than the GP who may not be available until after the aches from the gardening spurt have passed and the ‘dope’ depots are always there for the nocturnally mobile.
Why not keep it simple and stay with the devil we know and maybe get to know it even better.