There are many different medications for pain, known as analgesics, and they have varying strengths, effectiveness and implications for workplace safety.
Some of these drugs can be purchased at the supermarket or over the counter at a chemist, others for more severe or chronic forms of pain require a prescription.
The generally most effective painkillers for mild to moderate pain are paracetamol and the Non-Steroidal Anti Inflammatory Drugs (NSAIDs) which include aspirin and ibuprofen (Nurofen, Brufen).
None of these medications cause a positive drug test unless combined with another drug such as codeine.
Codeine is the most common form of the opiate (morphine-like) class of drugs and is available in low doses over the counter at chemists1.
Codeine is not very effective for pain and the Government is considering restricting its availability2.
Codeine and other opiates are depressants, slowing down the brain. They can cause drowsiness, slow reaction time and trouble thinking clearly.
This may affect safety at work - some studies showed up to twice the rate of motor vehicle accidents in drivers with codeine medications3.
Prescription-only opiate painkillers include trade names such as Mersyndol Forte, Panadeine Forte, OxyContin and MS Contin. The doctor should always consider effects at work.
All these drugs could cause a positive drug test screen depending on dose and time taken.
A laboratory confirmation test can determine the type of medication and the level of drug in the worker’s system. A Medical Review Officer (a doctor with special training in dealing with drug and alcohol issues at work) can provide advice on whether it may be being misused.
Workers should always consult their health professional about pain medication, why it is needed and its potential effect on safety at work.
1. DASA Fact sheet - Common over the counter medications that can cause a positive drug test 2. Joel Iedema Cautions with Codeine Australian Prescriber vol 34 2011 p133-15 3. LC Bachs The risk of motor vehicle accidents involving drivers with prescriptions for codeine or tramadol Clinical Pharmacology &Therapeutics vol 85 2009 p596-99
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