As you may already know, medicines containing codeine are no longer available for ‘over-the-counter’ purchases in pharmacies. The change has brought Australia into line with other countries, including the US, Japan and most of Europe, which has banned over-the-counter sales of medicines containing codeine.
What is codeine?
Codeine is an opioid drug closely related to morphine, and like morphine, is also derived from opium poppies. Codeine is an analgesic that is typically used to treat pain and used as cough medicine. Over the years, the drug has been present in both prescription and over-the-counter (OTC) medicines.
Impacts of the codeine ban
Following the ban, consumers will now need a prescription to obtain any medicine containing codeine. Even for low dose options such as Nurofen Plus and Panadeine, you’ll have to go through a doctor.  The ban also affects all codeine-containing cold and flu products such as Codral and Demazin.
Why has codeine become prescription only?
Research has shown that codeine-containing medicines provide little extra relief compared to medicines that do not contain codeine. In announcing the ban, the Therapeutic Goods Administration argued that, on top of being addictive, the drug has little benefit and is responsible for over 100 deaths each year.
Codeine is a commonly used medicine of abuse. When misused, codeine-containing medicines can cause harm regardless of the codeine dosage.
What are the risks of codeine?
Some of the risks associated with codeine use include;
1. Dependence
Codeine is highly addictive and can lead to dependence. Continued use results in building up a tolerance and subsequently, users need to take higher doses to feel the same relief from their symptoms. In 2013, the National Opioid Pharmacotherapy Statistics showed that codeine was the opioid drug of dependence for 1,038 clients receiving opioid substitution pharmacotherapy.
2. Morbidity
After continued use, individuals experience severe withdrawal symptoms making it impossible to carry out their daily activities. In serious cases, it can even result in hospitalisation. Withdrawal symptoms can include head and muscle aches, nausea, insomnia and diarrhoea. Â
3. Death
Over the last few years, the rates of fatal codeine-related overdoses in Australia have been increasing. Codeine-related deaths increased from 3.5 to 8.7 deaths per million persons between 2000 and 2009. According to a study by Roxburgh et al. (2015), codeine toxicity was the contributory factor in 1437 deaths.
Alternative solutions for chronic pain management
Chronic pain is more prevalent than it seems. For every five Australians, one lives with the condition. The number is even higher among those over the age of 65. Although the condition can be hard to cure, it can be managed with medicines and those containing codeine have been among the most popular go-to treatment options.
If you have been using medicines containing codeine to manage chronic pain, there’s no need to panic. There are lots of other codeine free medications that can be just as effective. It is advisable to consult your pharmacist or GP on the best alternative medicines for you.
However, while over-the-counter and prescription medicines are effective, a multidisciplinary approach is far more effective and has longer-lasting results. Combining medication with non-medicine interventions, such as cognitive behaviour therapy, physiotherapy and self-management tools such as physical exercise and relaxation techniques, is far more effective and could be exactly what you need.
Chronic pain can be tough to live with, but with the right approach, you can be able to reduce the pain and, over time, improve your quality of life.
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