Over-the-counter codeine ends Feb 1 in Victoria

Over-the-counter codeine ends Feb 1 in Victoria

NOTE: Please seek medical advice if any of this post refers to you. The purpose of this post is to educate the general public about the complexity of the situation not to provide medical or other advice.

FEBRUARY 1st, 2018

It's going to be a challenging time in GP clinics and clinics like First Step (specialising in addiction) when codeine and other opiate-based medications are no longer available over the counter (at the chemist without a prescription from a doctor). Codeine (a schedule 4 drug from Feb 1) prescriptions will be regulated by the Drugs and Poisons Unit of Department of Health and Human Services by monitoring prescriptions. Codeine is not a drug to be taken lightly and this move by the government is designed to highlight and minimise the dangers of excessive and unregulated use.

As the Age article below informs us, many thousands of Victorians are addicted to these medications, and their lives are set to change from Feb 1.

Bit of background:
Broadly speaking the ongoing, regular over-use of these medications is due to:

A. chronic pain and constant need for pain relief
B. inadvertent dependence (eg. needed pain relief for a while then couldn't stop taking the pills), or
C. significant psychological distress (for some people codeine functions like morphine and is habit forming due to a euphoric effect and/or reduction of psychological pain).

People taking these medications are likely to pursue one of the following options from Feb 1 onwards. They are listed here in no particular order and with no judgement (good or bad):

1) going cold turkey (ie. simply ceasing use of the medication)
2) seeking prescriptions for codeine from a GP (note: the maximum prescription will be 8 pills per day - some people are taking dozens). 
3) short-term prescription from a doctor for treatment regimes such a suboxone (suboxone is sometimes prescribed, and tightly controlled, for opiate dependence).
4) getting a referral to a pain clinic that might oversee a range of options (including non-pharmaceutical such as physiotherapy) to help manage pain.

Australia has still not reached the goal of 'real time prescribing' which would put a stop to doctor shopping, but in the interests of long term health and wellbeing replacement pain medication whether overseen by GP's or other specialist practitioners is likely to be prescribed on a reducing basis. There are exceptions to every rule but for the most part this would be a good thing. 
And there are two more possible directions that people might take:

4) If someone is going to the doctor for prescription analgesics (pain relief) they may decide to try for something more powerful. This would be the opposite of what the new regulations are hoping to achieve, and GPs should be particularly wary of this in the near future, 
5) Turn to street drugs (diverted prescription medications or illicit opiates such as heroin) which of course is also the opposite of what the regulations are seeking to achieve.

So . . . it's going to be a complicated time.

If any of this applies to you or someone you care about then you need a plan, and you need to talk to a doctor about it (probably start with your GP) and we would recommend you doing so sooner rather than later.



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