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Codeine law changes

My daughter and son in law just visited the US a month or so ago. They told me that any codeine containing medications required a doctor’s prescription to be able to obtain it. It may be available but if no prescription you are likely to be arrested if it is found in your possession.

Yeah, I get a prescription for 3 packs of demanding, as I’ve had issues for decades, & when I get hit with sinus headaches, I need something that dries.
My main problem is the government requiring the sale of something with zero benefit based on fears re making something illegal.
Policing should take a priority.
With codeine, I just see a small group of abusers causing an issue for the rest of us.
I suspect the people who are likely to abuse codeine now, will just switch to something much stronger & less legal.

Given the impetus for removing medications containing codeine was predicated on a very few instances of people buying and then abusing huge quantities of these same medications, stand by for paracetamol to be next. Overdosing is much easier to do than with codeine products and with the nanny state as it is, we perfectly sane and law abiding adults will be further ‘protected’ from the evils of pharmaceuticals abused by the few.

It would have been far better to introduce a nationwide computer based log to record sales of the ‘offending’ medications. Photo ID required to purchase them and every packet accounted for. This would have shown those customers who chemist shop for the huge quantities they wanted (some up to 120 tablets a day)
and allowed for clinical interventions. As it is we are all now punished for the actions of the few - AGAIN!

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There is a computer based log but it is voluntary. Apparently only about 60%of pharmacies have joined. I don’t know about other states but in NSW these products are kept behind the counter and you have to show ID to purchase them. I personally won’t be affected by the ban as I don’t use these products. If I need something stronger than paracetamol I go to the doctor.

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Advised by who(m) that OTC doses of codeine have no clinical value, yet you observe an effect and suspect placebo. Issue of standing to comment. A clinical trial of most medications will produce a bell shaped curve of responses and varying the dose complicates the matter. Placebo effects are also exaggerated. Your request for opinion produced a bell shaped curve of responses from informed to partially relevant to sad. PS. my tertiary studies were pharmacy, accounting, finance and law. Fifteen years ago I held a position in Canberra in the PBS Compliance arena - one of those brainless public servants. In Court an “expert” witness is required to demonstrate standing to have their opinion heard. Sadly this is not required in the political arena, hence the Hanson Lambie factor, and is matched in the public domain. Simplistic absolute statements such as almost everything sold in pharmacy is of dubious value and close snake oil sellers abound. A brief review of jurisdictional issues between Federal, State, Local and layers of professional organization will reveal nuances of complexity. Terms such as Nanny State, advocated by a Liberal Democrat Senator are often aired. A nuanced view was stated that G agencies have many social issues to deal with and labelling of food is being recognised as relevant to health. Limited resources must be applied to fry the biggest fish. Sadly, it is moronic politicians who decide resourcing and where to draw the line. The risk of harm from Meth cannot be overemphasised and this, as all medication abuse, cannot be stated as affecting the few. In reality it is closer to a few hundred thousand. My position may have permitted perusing the data for the doctor shopping issue. Data and real analysis should predicate comment rather than opinionated dogma, frequently initiated by political persuasion. The issue of switching from OTC codeine to illegal sources has the same cost/benefit and supply/demand drivers as any commercial product. The AFP may be across the matter. An informed discussion as to where to draw the line between individual freedoms viz harm avoidance to a minority is appropriate. Sadly the power elite have other drivers that are removed from the social good.

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Some of us had hoped that the war on drugs would wind down eventually, as logic finally made it through the heads of politicians, bureaucrats and law enforcement bodies. This ‘war’ has cost too many lives for absolutely no benefit - except to those making money from illicit drugs, and the police kept in a job arresting them. Oh, and one must not forget the prison industry.

The Therapeutic Goods Administration is currently in the same position that the Australian Bureau of Statistics was in collecting and keeping your information. In TGA’s case, it asked whether banning codeine was a good idea and got an overwhelming ‘no’ response. One must wonder about the point of consultation if you are not going to pay any attention to the responses - and wonder whether any politicians happened to discuss their expectations of the TGA.

The reason for this ban on over-the-counter codeine is ‘it’ll save lives’. Rubbish! The examples that are trotted out, of people who have died after taking too much medication with codeine, all tell the same story: they died of paracetamol poisoning or ibuprofen poisoning. Codeine is not killing people!

As for the Australian Medical Association, it has shown that it is currently a lackey to the currents of TGA opinion. I am disgusted that it has come out in support of this decision, as are many doctors. Certainly it means GP business will go through the roof - but we already have a GP shortage! This short-sighted populism will come back to haunt the AMA.

The TGA has argued that codeine is not available over the counter in much of the world (including the US, and parts of Europe and Asia). And…? I would prefer that public health policy not be run as a popularity contest!

Further reading on the TGA’s codeine decision:
Public submissions on scheduling matters referred to the ACMS #15, August 2015
Public submissions on scheduling matters referred to the ACMS#17 March 2016 (codeine)
Final decision on re-scheduling of codeine: frequently asked questions

I would be most appreciative if someone were able to track down an accounting of the ‘yays’ and ‘nays’ in the consultation processes linked above.

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Couldn’t agree more. In addition when laws are passed like this out beings into disrepute laws that might actually be worthwhile.

Well said. Evidence-based policy is conspicuous by its absence in our funny little banana republic.

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I agree with you completely panlezark! I have seen the news articles that say that codeine has no clinical analgesic effect, yet I can often treat a headache with one combined codeine/paracetamol tablet, rather than two plain paracetamol tablets. Unless this is actually a placebo effect, it is surely useful to be able to buy combined paracetamol/codeine tablets OTC to minimize how much paracetamol we use. Is it not paracetamol that is problematic for causing liver toxicity in large doses, more so than codeine?

Many medical practices are struggling to effectively service their communities as they are already too busy. There have been times when I have had to call 6 plus medical centers to get an appointment within 24 hours. My closest practice won’t take on any new clients at all (I check every year or so, and they suggest that I write a letter to the practice to see if they will consider taking me on as a patient when a space comes up …it feels a bit like applying for a job!). I imagine that needing a prescription to get these codeine combined analgesics is just going to put more pressure on the already stretched medical system.

On a side note, I went to my local pharmacy last week to get a sterile needle to remove a splinter with. I was told that they are no longer permitted to sell needles (except for insulin needles for diabetics or drug addicts …which are useless for splinters, but no doubt carry what ever perceived dangers that other sterile needles carry!). I asked for a small scalpel, but they are not permitted either, so I asked for a splinter remover …and apparently you need to buy an entire first aid kit to get one of those. So soon we may need to see our poor GPs every time we have a small splinter requiring removal, as well as basic headaches, aches and pains that respond to codeine combinations.

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With reference to part of the comment by hey_trace. I was wanting to buy several sterile scalpels for a particular reason and was refused at the local chemist. I went across to the produce store…no problem. I was asked how many did I want!!!

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One can made a sterile needle by placing a sowing needle over a hot flame until red, cool in the air while holding then use. Care taken not to burn oneself.

This is something used in microbiology laboratories when a sterile needle is needed.

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Also many craft shops sell sterile scalpels as hobby knives.

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I hate being made to feel like a drug addict every time I need Sudafed. I’ve tried all the PE brands and nothing else works to clear my sinuses. Some chemists don’t seem to care too much but I’ve actually been refused service because it was my second pack in a month. It’s gotten to the point where I try to stretch out any pack I can get for as long as possible but then I end up with headaches, which is not touched by panadol but is helped by codeine, now I can’t get those either!

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Although Forbes is a US business magazine, this article and references cited are relevant. “PE” is essentially a government supported placebo that benefits the drug companies and apparently provides no evidence of efficacy. I for one have long stopped wasting my money on it, and like yourself, run the gauntlet of being treated like a criminal for wanting something that does more than extract dollars from my pocket.

Until about a decade ago one could buy a bottle of 500 pseudoephedrine tablets in the US for about $USD20 (American everything gets giant sized, let’s leave it at that); now, like Australia, they are about $1 per tablet. Codine is going the same way because of our government saluting whatever the US does and wants, to both control drugs and to enrich drug companies wherever possible.

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Melony
I guarantee you that the PE versions do nothing other than provide possible relief from any pain killing ingredients.
The ‘active’ ingredient phenylephrine hydrochloride, in tablet form, has never shown to have any impact on sinuses/ runny noses.
As a, short term, spray, it can dry you up, so maybe try it in spray form.
It’s ludicrous that the government allows, much less encourages a placebo to be the preferred treatment of anything, but that is what we have.
On codeine, the arguments are weird. The likelihood of overdose on paracetamol is higher than codeine overdose, yet I’ve had the codeine overdose argument thrown up more often than anything else.

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Agree with you on this, but I have not generally heard anyone argue that it’ because of the codeine. The argument is that people are overdosing on paracetamol or ibuprofen while trying to get a decent hit of codeine. This is what happened with a guy in Victoria who took way too many ibuprofen tablets.

So - how do you solve thrill-seekers killing themselves on the ‘adjunct’? (A bit like heroin users filling their veins with the bleach that was used to bulk it up.) Do you say “Okay, you can’t get it at all” (something that has utterly failed in the ‘war’ on drugs)? Or should you say “Well, maybe we should make safe amounts of codeine available with safe amounts of ibuprofen/paracetamol”?

The ‘war’ on drugs has failed dismally in its claimed purpose. It has helped the US to keep African-Americans poor, and to ensure that the ‘white trash’ has no hope; it seems to serve similar purposes here, for Indigenous Australians. It has not, and never will, keep drugs out of the hands of people who want them. So how about treating drug misuse as a medical problem, as should have been done all along?

Recommended reading: Chasing The Scream, by Johann Hari.

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Codeine is now no longer sold without a prescription.

Read more:

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My local pharmacist indicated his opinion, that the law will be reversed in six to twelve months because of all the unintended consequences. I can but hope.

While I keep hearing (some) doctors and politicians say that ‘low dose codeine does nothing for pain’, I suspect that these individuals have never really had to deal with pain. Aspirin, paracetamol and ibuprofen do a decent job in many people with low-level pain, but for a large proportion of the population they are insufficient to deal with our experienced pain. (Aspirin is the best of the lot, but comes with its own problems.)

While I am already on something stronger for chronic pain, millions of other Australians who have relied upon OTC painkillers to get through their day will now have to go to the doctor to get something that will enable them to function. I expect that this will result in many of them requesting and being prescribed stronger painkillers - because of course we all know that low doses of codeine don’t help (/sarcasm alert).

So more Australians will be taking stronger painkillers with more serious side-effects, all because a couple of people died through an overdose of ibuprofen or paracetamol that happened to contain the codeine they may actually have been after.

The TGA has chosen to ignore most of the advice it has received on this issue. The AMA has been happy to encourage the idiocy, in the knowledge that it will create greater demand for doctors (and of course greater pressure on them, on Medicare, and on the PBS, because these painkillers that were previously OTC will now be subsidised for many patients).

All up, I expect some major ‘unanticipated’ (and many anticipated but ignored) consequences - one of which will be that anything with codeine will now cost more as prescription medication.

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One just need to look toward the USA that leads most of these ‘charges’. Evidence does not usually matter, politics and dogma do.

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Here’s another scenario to consider. Whether it’s common or not I don’t know - but it affects BOTH my wife & I.

My wife has Crohns - her Doc makes sure she always has strong Codeine on hand. I occasionally have major back issue & stiff neck. Now when my Wife’s Crohns flares or I cop a back or neck incident - we have her stash on hand but often “previously” chose to use low dose first or instead. We “don’t” like taking the strong stuff unless we really “need” it & in BOTH her & my case the times we need it are only occasional but the last thing we want to do is leave the house to go anywhere! So if we didn’t have low dose obviously the partner would just go pick some up - Doh!

To me it’s just a major PIA both in convenience & cost, but we will likely be fine as due to my Wife’s condition I don’t see the Doc having any qualms at all giving her whatever she want - script for both low & high dose so she has it on hand.

Mind you at the same time I think we have been lucky; visited Japan a few times & try getting anything for pain in Japan LOL At the same time I really don’t believe this is going to help the problem that they have brought it in for in any way. If people want it & to abuse it they will find a way!!! full stop!!!