Painkillers with codeine to require scripts from 2018

Painkillers containing codeine will be available only with a script from 2018.

Painkillers containing codeine will be available only with a script from 2018, after experts deemed the risk of addiction and overdose too serious to allow pharmacists to sell the drugs without the involvement of a doctor.

The Australian understands the Therapeutic Goods Administration will press ahead with the controversial upscheduling of codeine products, after intensive deliberations and consultations that have continued for more than a year.

Painkillers such as Nurofen Plus and Panadeine and some cold and flu drugs are currently available over the counter at pharmacies, where there is considerable variation in the rigour applied to requests and also the reporting ­requirements.

The TGA is likely to announce its decision before Christmas, with a lead-in period of more than 12 months reflecting the need for those with chronic pain to seek ­advice and make alternative ­arrangements with their doctor.

Although the move will have an impact on those who manage chronic pain responsibly, and who will be required to go to the effort and expense of seeing a doctor, it is intended to save lives.

A study in the Medical Journal of Australi a showed the rate of ­codeine-related deaths more than doubled between 2000 and 2009. Coronial data showed 48.8 per cent of the 1437 deaths in the ­period were accidental and such fatalities were becoming more common.

Commonwealth, state and territory governments have been aware of the problem of codeine abuse for some years, however the interventions discussed by ministers have either not been implemented or proved ineffectual.

A 2012-15 intergovernmental action plan listed as its top priority a national electronic recording system to track purchases of ­codeine products, and also recommended better labelling and smaller pack sizes.

The action plan warned that painkillers and also tranquillisers were causing increasing addiction, overdoses, trafficking and crime. There was concern, with the ageing population, that the prevalence of painful conditions and anxiety disorders would only increase, raising the risk of a new, older generation of drug addicts.

When the TGA first flagged upscheduling codeine in October last year, it proposed a six-month lead-in time.

“Changing the labelling and decreasing the pack size will not adequately address the problem,” it concluded.

The response from health stakeholders and patients prompted the TGA to revisit the issue and consult more widely. The Australian Medical ­Association and the Pharmacy Guild again called for an electronic recording system, however the computer-based solution put forward by the commonwealth in 2012 has failed to win state support. At the Council of Australian Governments health council meeting in October, federal Health Minister Sussan Ley asked the states to provide an update on progress with an electronic ­recording system this month.

It appears the TGA made its decision separate to any other considerations. It comes amid an ongoing Medicare freeze and concerns that people will pay more to see a doctor in future.

The Australian Self-Medication Industry has previously warned the additional cost to Medicare would be $170 million a year and the extra cost to consumers would be $70m a year.