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    Consumer fact sheet: Codeine-containing medicines: Harms and changes to patient access

    Consumer fact sheet: Codeine-containing medicines: Harms and changes to patient access

    P
    @powderhownd1492
    2 Followers
    5 months ago 251

    From February 1, 2018, codeine-containing medicines will require a prescription. This change aims to reduce harm due to codeine's addictive properties and associated health risks. Pharmacists will guide patients to safer alternatives. It's vital for individuals to consult their doctors for proper pain management strategies, especially if they experience withdrawal symptoms or chronic pain.

    Codeine-containing medicines
Harms and changes to patient access
What’s changing?
From 1 February 2018, medicines that contain codeine will no longer be 
available without prescription. 
Your pharmacist will be able to help you choose from a range of 
effective products that do not require a prescription. If you have strong 
or chronic (long-lasting) pain you will need to consult your doctor, and if 
medicines are part of your treatment, a prescription may be needed. 
Why is access to codeine changing?
Some Australians don’t realise how much harm codeine can cause.
Most Australians are unaware that over-the-counter medicines 
containing codeine for pain relief offer very little additional benefit when 
compared with medicines without codeine. The use of such medicines, 
however, is associated with high health risks, such as developing 
tolerance or physical dependence on codeine. 
Codeine is an opioid drug closely related to morphine and, like 
morphine, is derived from opium poppies. Codeine can cause opioid 
tolerance, dependence, addiction, poisoning and in high doses, death.
Codeine use can be harmful
Tolerance occurs when codeine becomes less effective and so the 
body needs higher and higher doses to feel the same relief from 
your symptoms. Severe withdrawal symptoms can result when the 
medicine is stopped; these include head and muscle aches, mood 
swings, insomnia, nausea and diarrhoea. Some of these withdrawal 
symptoms, such as head or muscle aches mimic the symptoms that 
low-dose codeine products are often used to treat, leading to people 
incorrectly continuing to take the medicine longer or in higher doses. 
Codeine poisoning contributes to both accidental and intentional 
deaths in Australia. The codeine-containing medicines that are 
currently available over-the-counter are usually combined with either 
paracetamol or ibuprofen. Regular use of medicines containing codeine, 
for example for chronic pain, has led to some consumers becoming 
addicted or tolerant to codeine without realising it. Taking more than 
the recommended dose of combination products could result in serious 
side effects. Though safe at recommended doses, long term use of high 
doses of paracetamol can result in liver damage while the most severe 
adverse effects of long term ibuprofen use include serious internal 
bleeding, kidney failure and heart attack. 
Codeine use can lead to tolerance, 
dependence, addiction, poisoning 
and even death
Major symptoms include:
Headache Drowsiness
Dizziness
Nausea
Constipation
Difficulty breathing
Addiction and 
tolerance
    1/2
    Codeine is also sometimes used in medicines to relieve the symptoms of 
cough and cold, however there are safer and more effective medicines 
available that may provide relief from these conditions. Talk to your 
pharmacist or doctor for advice on what may be best for you.
How and where to get advice
Pharmacists have an important role to play in minimising harm 
from codeine.
The current range of codeine-containing over-the-counter medicines 
will continue to be available without a prescription in pharmacies until 
31 January 2018. Pharmacists will continue to be an important source of 
information and advice for consumers both before and after this date.
Most people should be able to manage acute pain or cough and 
cold symptoms with safer medicines. For acute pain, this may include 
products containing paracetamol or ibuprofen, or the two products 
in combination. Your pharmacist will be able to provide advice on the 
most appropriate medicines for you. Speaking with your pharmacist is 
particularly important if you have any other medical conditions, such as 
stomach, kidney, liver or heart problems.
Talk to your doctor
People with ongoing pain should talk to their doctor or healthcare 
provider to determine better alternative treatment options. These 
may include: alternative over-the-counter or prescription medicines; 
non-medicine therapies from an allied health professional such as a 
physiotherapist; self-management tools such as exercise or relaxation; or 
referral to a pain specialist or pain management clinic.
Ask your doctor about a Medicare-funded care plan which will allow 
you access to a rebate for treatment from an allied health professional. 
Medicare provides a rebate for the preparation of a Chronic Disease 
Management Plan and a Team Care Arrangement. For more information 
see www.health.gov.au/internet/main/publishing.nsf/content/
mbsprimarycare-chronicdisease-pdf-infosheet. 
If you think that you are unable to manage without codeine and 
experience some of the side effects of withdrawal talk to your doctor 
about getting help.
Next steps
A Nationally Coordinated Codeine Implementation Working Group 
(NCCIWG) has been established with representatives from state and 
territory health departments and peak professional bodies representing 
consumers, pharmacists and medical professionals. The purpose of this 
working group is to assist with the implementation of a communication 
strategy to help inform the community of the upcoming changes 
to the availability of low-dose codeine containing medicines from 
1 February 2018.
Advice for pharmacists and medical professionals regarding the 
changes to codeine access and to help them provide the best advice 
to their patients will be made available on the Department’s website at 
www.health.gov.au. 
For more information and support:
NPS MedicineWise
www.nps.org.au 
Alcohol and Drug Information Service 
(ADIS)
www.drugs.health.gov.au
Pain Australia
www.painaustralia.org.au
Chronic Pain Australia
www.chronicpainaustralia.org.au 
painHEALTH
https://painhealth.csse.uwa.edu.au 
Australian Pain Management Association
www.painmanagement.org.au 
Ask Your Pharmacist:
askyourpharmacist.com.au
Pain Management Network
www.aci.health.nsw.gov.au/chronic-pain 
Pain Link Helpline
1300 340 357
Healthdirect Australia - 24 Hour Health 
Advice Line: 1800 022 222
Contact information for state and 
territory drugs and poisons units
ACT Health
Pharmaceutical Services: www.health.act.
gov.au/public-information/businesses/
pharmaceutical-services
NSW Ministry of Health
Pharmaceutical Services: www.health.nsw.
gov.au/pharmaceutical/Pages/default.aspx
NT Department of Health
Environmental Health – Medicines and 
Poisons Control: https://health.nt.gov.
au/professionals/environmental-health/
medicines-and-poisons-control
QLD Health
Medicines Regulation & Quality Unit: 
www.health.qld.gov.au/clinical-practice/
guidelines-procedures/medicines 
Poisons Management: www.health.qld.gov.
au/system-governance/licences/medicinespoisons/poisons-management
SA Health
Medicines and Technology Policy and 
Programs: www.sahealth.sa.gov.au/MTPP
TAS Department of Health & Human 
Services
Pharmaceutical Services: www.dhhs.tas.gov.
au/psbtas/welcome
VIC Department of Health & Human 
Services
Drugs and Poisons Regulation: www.health.
vic.gov.au/dpu/
WA Health
Pharmaceutical Services: www.public.
health.wa.gov.au/1/872/2/pharmaceutical_
services.pm
    2/2

    Consumer fact sheet: Codeine-containing medicines: Harms and changes to patient access

    • 1. Codeine-containing medicines Harms and changes to patient access What’s changing? From 1 February 2018, medicines that contain codeine will no longer be available without prescription. Your pharmacist will be able to help you choose from a range of effective products that do not require a prescription. If you have strong or chronic (long-lasting) pain you will need to consult your doctor, and if medicines are part of your treatment, a prescription may be needed. Why is access to codeine changing? Some Australians don’t realise how much harm codeine can cause. Most Australians are unaware that over-the-counter medicines containing codeine for pain relief offer very little additional benefit when compared with medicines without codeine. The use of such medicines, however, is associated with high health risks, such as developing tolerance or physical dependence on codeine. Codeine is an opioid drug closely related to morphine and, like morphine, is derived from opium poppies. Codeine can cause opioid tolerance, dependence, addiction, poisoning and in high doses, death. Codeine use can be harmful Tolerance occurs when codeine becomes less effective and so the body needs higher and higher doses to feel the same relief from your symptoms. Severe withdrawal symptoms can result when the medicine is stopped; these include head and muscle aches, mood swings, insomnia, nausea and diarrhoea. Some of these withdrawal symptoms, such as head or muscle aches mimic the symptoms that low-dose codeine products are often used to treat, leading to people incorrectly continuing to take the medicine longer or in higher doses. Codeine poisoning contributes to both accidental and intentional deaths in Australia. The codeine-containing medicines that are currently available over-the-counter are usually combined with either paracetamol or ibuprofen. Regular use of medicines containing codeine, for example for chronic pain, has led to some consumers becoming addicted or tolerant to codeine without realising it. Taking more than the recommended dose of combination products could result in serious side effects. Though safe at recommended doses, long term use of high doses of paracetamol can result in liver damage while the most severe adverse effects of long term ibuprofen use include serious internal bleeding, kidney failure and heart attack. Codeine use can lead to tolerance, dependence, addiction, poisoning and even death Major symptoms include: Headache Drowsiness Dizziness Nausea Constipation Difficulty breathing Addiction and tolerance
    • 2. Codeine is also sometimes used in medicines to relieve the symptoms of cough and cold, however there are safer and more effective medicines available that may provide relief from these conditions. Talk to your pharmacist or doctor for advice on what may be best for you. How and where to get advice Pharmacists have an important role to play in minimising harm from codeine. The current range of codeine-containing over-the-counter medicines will continue to be available without a prescription in pharmacies until 31 January 2018. Pharmacists will continue to be an important source of information and advice for consumers both before and after this date. Most people should be able to manage acute pain or cough and cold symptoms with safer medicines. For acute pain, this may include products containing paracetamol or ibuprofen, or the two products in combination. Your pharmacist will be able to provide advice on the most appropriate medicines for you. Speaking with your pharmacist is particularly important if you have any other medical conditions, such as stomach, kidney, liver or heart problems. Talk to your doctor People with ongoing pain should talk to their doctor or healthcare provider to determine better alternative treatment options. These may include: alternative over-the-counter or prescription medicines; non-medicine therapies from an allied health professional such as a physiotherapist; self-management tools such as exercise or relaxation; or referral to a pain specialist or pain management clinic. Ask your doctor about a Medicare-funded care plan which will allow you access to a rebate for treatment from an allied health professional. Medicare provides a rebate for the preparation of a Chronic Disease Management Plan and a Team Care Arrangement. For more information see www.health.gov.au/internet/main/publishing.nsf/content/ mbsprimarycare-chronicdisease-pdf-infosheet. If you think that you are unable to manage without codeine and experience some of the side effects of withdrawal talk to your doctor about getting help. Next steps A Nationally Coordinated Codeine Implementation Working Group (NCCIWG) has been established with representatives from state and territory health departments and peak professional bodies representing consumers, pharmacists and medical professionals. The purpose of this working group is to assist with the implementation of a communication strategy to help inform the community of the upcoming changes to the availability of low-dose codeine containing medicines from 1 February 2018. Advice for pharmacists and medical professionals regarding the changes to codeine access and to help them provide the best advice to their patients will be made available on the Department’s website at www.health.gov.au. For more information and support: NPS MedicineWise www.nps.org.au Alcohol and Drug Information Service (ADIS) www.drugs.health.gov.au Pain Australia www.painaustralia.org.au Chronic Pain Australia www.chronicpainaustralia.org.au painHEALTH https://painhealth.csse.uwa.edu.au Australian Pain Management Association www.painmanagement.org.au Ask Your Pharmacist: askyourpharmacist.com.au Pain Management Network www.aci.health.nsw.gov.au/chronic-pain Pain Link Helpline 1300 340 357 Healthdirect Australia - 24 Hour Health Advice Line: 1800 022 222 Contact information for state and territory drugs and poisons units ACT Health Pharmaceutical Services: www.health.act. gov.au/public-information/businesses/ pharmaceutical-services NSW Ministry of Health Pharmaceutical Services: www.health.nsw. gov.au/pharmaceutical/Pages/default.aspx NT Department of Health Environmental Health – Medicines and Poisons Control: https://health.nt.gov. au/professionals/environmental-health/ medicines-and-poisons-control QLD Health Medicines Regulation & Quality Unit: www.health.qld.gov.au/clinical-practice/ guidelines-procedures/medicines Poisons Management: www.health.qld.gov. au/system-governance/licences/medicinespoisons/poisons-management SA Health Medicines and Technology Policy and Programs: www.sahealth.sa.gov.au/MTPP TAS Department of Health & Human Services Pharmaceutical Services: www.dhhs.tas.gov. au/psbtas/welcome VIC Department of Health & Human Services Drugs and Poisons Regulation: www.health. vic.gov.au/dpu/ WA Health Pharmaceutical Services: www.public. health.wa.gov.au/1/872/2/pharmaceutical_ services.pm


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