Medical and health consumer advocates have published an open letter to state and territory Health Ministers, warning that any changes to the Therapeutic Goods Administration's (TGA) plan to make codeine prescription-only will put health and lives at risk.
In the open letter, experts reiterate key findings from the TGA's review of codeine use:
- Codeine is not effective for treatment of chronic (long-term) pain.
- There are serious risks of harm associated with codeine use, including death, toxicity and dependence.
- There are over-the-counter alternatives available that are a combination of ibuprofen and paracetamol that have been found to be a more effective analgesic than over-the-counter codeine containing analgesics.
- Multidisciplinary pain management is the most effective way to treat chronic pain.
The letter expresses concern that lobbying by the Pharmacy Guild of Australia (the 'Guild') has gained traction with state and territory Health Ministers.
"We are concerned about the proposal to establish a new alternative model to enable pharmacists to dispense non-prescription codeine, especially in rural areas where the Guild argues that there are limitations on patients being able to access a GP after-hours," the letter states.
"However, the reality is that in many rural towns pharmacies do not operate extended trading hours, leaving patients unable to access pain relief regardless of whether codeine is available over-the-counter.
"The Guild's proposed alternative model carries a serious risk of increased harms and potentially preventable deaths and cannot be supported by the medical community or consumer advocates.
"We also note that any decision by a state or territory not to implement nationally consistent scheduling controls would have serious and far-reaching implications that could affect public confidence in the ability of that government to protect public health and safety.
"We would be seriously concerned if the Guild's lobbying of state and territory governments included any suggestion that individual jurisdictions create exemptions that would be tantamount to walking away from nationally consistent regulation of medicines in this country.
"The success of the national strategy to reschedule codeine rests on all key stakeholders, including state and territory governments and peak bodies representing consumers, pharmacists and medical professionals, engaging and supporting this process."
Signatories to the letter include:
- Carol Bennett, CEO, Painaustralia
- Dr Ewen McPhee, RDAA President
- Dr Bastian Seidel, RACGP President
- Leanne Wells, CEO, Consumers Health Forum of Australia
- Dr Catherine Yelland PSM, RACP President
The scheduling changes are due to commence on 1 February 2018.