The Therapeutic Goods Administration (TGA) has announced that from February 2018 medications containing codeine currently available over the counter (OTC) at pharmacies will require a prescription (1). Codeine is a painkiller in the opiate class of drugs. It is found in low doses in combination with other drugs such as paracetamol, ibuprofen and pseudoephedrine in medications such as Nurofen Plus, Panadeine and some cold and flu formulations. In Australia these medications are currently available in pharmacies without a prescription and there were a total of 21.6 million packs of these drugs purchased in 2015 (2). This large and unrestricted use of a potentially harmful medication has caused considerable concern to health professionals and has led to a review by the TGA.
The TGA confirmed these potential harmful effects stating “Misuse of OTC codeine products contributes to severe health outcomes including liver damage, stomach ulceration, respiratory depression and death” and that “consumers frequently become addicted to codeine”. Despite their widespread use, the regulator confirmed that there was “little evidence low dose codeine medications were any more effective for pain relief or cough than similar medicines without codeine.” As such these medications will no longer be available without prescription from February 2018, when it is expected the use of these drugs will decrease dramatically.
In the meantime, however, the unrestricted use of these drugs will continue to have considerable impact in the workplace. As codeine is part of the opiate class of drugs it can produce a positive result in either a urine or oral fluids onsite drug test. The only way to confirm that it is a legitimate medication rather than a drug of abuse is by sending a sample to the laboratory. Moreover, in the case of urine, a chronic codeine user is difficult to discriminate from a heroine user as they both produce morphine in the sample. The workplace has to stand the worker down while awaiting the result which impacts productivity and costs. In addition, as highlighted by the TGA report, regular use of these medications without the supervision of a physician can lead to considerable adverse health impacts on workers.
DASA has the scientific, medical and OHS expertise to assist workplaces to incorporate accurate and effective information into their wellness programmes and educate their workers regarding the adverse impacts of these medications prior to their the restrictions coming into force in 2018.
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