Codeine – why the change?

As many individuals will be aware, from the 1st of February 2018, products containing codeine now require a prescription.

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There are a number of reasons why the government has made this change.

1. Evidence indicates there is no additional benefit in using small doses of codeine (lower than 30mg) over products without any codeine (Pain Australia, n.d.).
2. Codeine use can result in tolerance, physical dependence and even death (Pain Australia, n.d.) when used inappropriately and without monitoring from your doctor.
3. The codeine products previously available were combined with other medicines such as paracetamol or ibuprofen. Overdosing on these medications in an attempt to control pain commonly increased liver damage, internal bleeding, kidney failure and heart attacks (Pain Australia, n.d.).

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Generally speaking there is a three-step approach to pain management.

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1. Paracetamol:

Taking paracetamol regularly (eg taking two Panadol tablets four times a day or 2 Panadol Osteo tablets three times a day) is the first step in managing pain. Although this may not relieve all of the pain it reduces the need for high doses of additional medications associated with increased side effects.

2. Anti-Inflammatory Medicines:

Such as ibuprofen (Nurofen or Advil) or diclofenac (Voltaren). These medicines alleviate pain in a different way to paracetamol and can be taken at the same time. They are particularly good at treating pain associated with inflammation such as back or dental pain but cannot be used when other conditions are present such as high blood pressure, stomach ulcers, or in individuals with heart or kidney problems.

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3. Opioids:

When additional pain relief is needed or when anti-inflammatory cannot be used opioid medicines such as codeine are recommended. Sufficient doses to provide pain relief can be prescribed by your doctor with continual monitoring reducing the potential for severe side effects. It is important to realise that pain is often difficult to treat, with a variety of measures needed to control symptoms. Medication is one part of the puzzle but other measures such as heating and cooling products (rubs, patches and wheat bags), physiotherapy and gentle exercise can all be part of effective treatment.

For more information on the different types of pain medications or for other ideas on how to best manage your pain, talk to your Bendigo UFS pharmacist, we are always here to help!

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References:
Pain Australia Codeine Fact Sheet. (n.d.) Pain Australia. Retrieved From: www.painaustralia .org.au