By Peter Douglas

A ban on over-the-counter sales of codeine-containing products could realise major health benefits, according to medical experts in the Yarra Ranges.
As of Thursday 1 February, Australians have been unable to purchase codeine-based medication from pharmacies and shops, after the Therapeutic Goods Administration-backed decision was introduced nationally.
Hugely popular products such as Panadeine, Nurofen Plus and Mersyndol now can’t be obtained without a prescription from a general practitioner, in what is a huge shake-up for the pharmaceutical industry.
Federal Health Minister, Greg Hunt, has cited a worldwide opioid crisis as the reason behind the move.
Despite concerns among both the public and the medical fraternity over the ban, local experts have thrown their support behind the decision.
Inspiro Community Health’s Dr Tamsin Short, who manages the Medication Support and Recovery Service in Eastern Melbourne, expects the move will benefit the outreach offices at Lilydale, Belgrave and Healesville.
“The statistics out there suggest this needed to happen. Particularly with codeine-related products and when it comes to pain management,” Dr Short said.
“We want to encourage alternative ways to deal with pain management, not just through self-prescribing codeine. Perhaps it could be as simple as stretching, using a freezer bag or even practicing mindfulness.
“Many health professionals feel the same way and are supportive of the move.”
Dr Short said while the change may be inconvenient for some users, there is a high likelihood it could uncover hidden misuse.
Codeine is a highly addictive drug that, if misused, can cause hospitalisation, organ damage and even death.
Dr Short said the main message medical experts wanted to express is that “there is help available for you”.
“There is a stigma around this, but we see addiction as a health issue and we treat this as such,” Dr Short said.
Meanwhile, Emerald Medical Centre’s Dr Chris Madden has spent many hours preparing the clinic for the change, as well as developing its policy.
Dr Madden admitted he held some initial reservations about the decision, but was now fully supportive of the move.
“This may be the opportunity to set out a better course of action, rather than self-prescribing. Codeine is highly addictive and can result in severe withdrawals,” Dr Madden said.
“People can quickly find themselves in trouble with codeine.”
Dr Madden, who is a UK-born GP, has come from a system where there are no over-the-counter sales of codeine-based products.
Dr Madden said it is now the clinic’s policy not to prescribe codeine upon the first visit and without exploring the patient’s medical history.
“I’m not saying it will never happen, but we don’t want to send the message that you can just walk in and expect to get a prescription,” Dr Madden said.
“We may have a look at your medical history and see what alternatives are out there.
“It’s not like we won’t still prescribe codeine, but we want to make sure that it is the correct pathway for short-term pain management.”
Healesville GP, Dr Elroy Schroeder, said it was the right decision from the Government, with plenty of evidence that codeine is being widely abused on a national scale.
“There is proof out there that addicts would prefer to purchase in bulk and then crush it up, rather than having to score on the street,” Dr Schroeder said.
“This knowledge is shared among addicts, that codeine in a high enough dose can produce a morphine-like effect.”
Some statistics report about 153,000 Australians, or about one in five users, use codeine at rates that could indicate dependence.
Meanwhile, clinicians have reported a surge in referrals for misuse.
For further information, or to seek assistance, call the Medication Support and Recovery Service on 1800 931 101, or visit www.msrs.org.au.

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