Scripts for codeine drugs soared after it was made prescription only

Codeine is addictive and kills 100 people a year. Yet moves to cut its use have barely made a dent.

Prescriptions for codeine medicines have soared after the government made the addictive drug available by prescription only in February.

And the nation’s peak pain management body Pain Australia is calling for a complete overhaul of the way chronic pain is treated including new Medicare funding for up to 20 specialised pain management appointments a year.

Doctors wrote nearly three million scripts for subsidised codeine medications like Panamax Co and Panadeine Forte in the eight months between February and October this year, an increase of 319,516 on the previous year.

The scale of the problem is likely even worse because data does not include information on the sales of many codeine containing products like Nurofen plus which is available by private prescription only and is not on the national drug subsidy scheme.

The shift to make codeine prescription only was to head off growing addiction to the medicine which was estimated to be killing 100 Australians a year.

Prescriptions of drugs like Panadeine Forte increased after over the counter sales of codeine were banned. Picture News Corp

Usage of codeine remains high even though the price of these previously over-the-counter medications has increased and chemists were able to add a dispensing fee of up to $7.

Concerningly, it appears pensioners and welfare recipients have switched from 8mg doses of the medications to 30mg doses because the stronger dose is subsidised by the Pharmaceutical Benefit Scheme and is cheaper.

Data provided by the Pharmacy Guild of Australia shows prescriptions for codeine medications increased from 2,464,101 between February and October 2017 to 2,783,617 between February and October 2018.

A spokesman for the Guild said the increase in the prescribing of higher dose 30mg codeine products this year was one of the expected consequences of the decision to upschedule the lower dose medicines containing codeine.

“More time and analysis of data for PBS and non-PBS medicines will be required to gain a clearer picture of the impact of the upscheduling,” the spokesman said.

It was estimated around six million doses of the medications were sold each year when they were available over the counter.

Even though prescriptions have increased they do not appear to have reached levels that would replace that level of usage.

However, the data has raised questions about whether doctors are pulling their weight in tackling the problems caused by the medication which can be deadly.

Pain Australia CEO Carol Bennett. Picture supplied.

Pain Australia CEO Carol Bennett said the increased prescription rate did concern her and part of the problem was GPs weren’t properly trained in how to manage chronic pain.

“I don’t think doctors have a lot of good options or alternatives and what we understand in the community is that when you are in pain you are medicated,” she said.

Australian Medical Association president Dr Tony Bartone said it would take some time to reduce the use of codeine products because people who had become dependent on them had to be gradually weaned off the drugs.

“We need more pain management clinics and specialists to refer problem patients to,” he said.

Pain Australia has been tasked by the government with drawing up the nation’s first pain strategy.

The group said a multidisciplinary approach that involves physiotherapy, exercise, psychological help and sometimes changes to the diet is needed.

It has published a list of 50 things doctors can do to help chronic pain without using codeine.

Its pain strategy is currently awaiting ministerial approval.

The strategy calls for people with chronic pain to get similar help from Medicare as those suffering a mental illness — 10 to 20 subsidised visits a year to health professionals who are experts in pain management.