As of the 1st of February 2018, all medicines containing codeine will become prescription only. Research has shown that over-the counter low-dose (<30mg) medicines that have codeine offer small pain relief treatment when compared to medicines without codeine. Use of codeine can cause opioid tolerance dependence, poisoning and in high doses, death. Regular use of codeine for pain relief has resulted in some consumers becoming opioid dependent without realising.
GP and Practice Nurses
You may see an increased number of patients asking for Codeine for pain relief in your practice. Not every patient will be codeine dependant, however it is important that GPs are able to identify codeine addiction and manage accordingly. In October 2017 Sydney North Primary Health Network hosted an education evening to support GPs to manage the changes, and there will be another event on Saturday the 10th of February from 11am-1pm.
For more information about this event please click here.
Educational Videos and Webinars
Created by a collective of addiction specialists in Australia, a series of educational videos have been produced to assist GPs to identify drug seeking and dependent patients, understand their current abuse of drugs, how to say no, guidance for referring patients to opioid substitution programs and more. GPs will be introduced to new guidelines that allow prescribing of schedule 8 medications without further training in Opioid Substitution Treatment.
Access the videos here.
Webinar: Opioid Treatment in General Practice: Assessing for dependency and understanding treatment options. This RACGP webinar supports GPs to manage patients who are having issues with pharmaceutical opioids.
The NSW Opioid Treatment Program
The NSW Opioid Treatment Program (OTP) aims to reduce harms associated with opioid use. For information about gaining authorisation to enrol a patient onto the OTP programme, becoming and accredited prescriber click here.
Scriptwise have created a prescriber toolkit that includes modules on chronic pain, knowing when to refer, dependence and addiction, codeine and the PBS and why codeine is being rescheduled.
New Opioid Treatment Guidelines
- Abbreviated Guidelines
- Full Guidelines
- Key Differences between the 2006 OTP guidelines and the 2018 OTP guidelines
- Additional points to note OTP Guidelines 2018
- Managing opioid dependence in pregnancy: A general practice perspective provides an overview of treatment principles for managing opioid dependence in pregnancy, and reviews current treatment guidelines for use of opioid-substitution therapy in pregnant women.
TGA’s Codeine Hub
The Therapeutic Goods Association (TGA) has developed a Codeine Hub that contains education resources including factsheets and conversational tips for managing patients.
Additionally, the TGA provided a series of workshops throughout Australia. Presentations from each of the workshops are listed below:
Videos taken from each topic at the Melbourne workshop are below:
- Professor John Skerritt & Avi Rebera – Changes to codeine product access: Background to the decision to change to prescription-only
- Pene Wood – Alternative options to codeine in the pharmacy
- Dr Malcolm Hogg – Rethinking our approach to pain and the role of opioid therapy
- Dr Mathew Frei – Over the counter, down the hatch: OTC codeine use
- Dr Malcolm Hogg – Delivering pain management in a rural setting
- Panel Q&A Session
The Pharmaceutical Society of Australia (PSA) and Pharmacists Guild have developed online training to assist pharmacists to prepare for the re-scheduling. Included in the first module is an overview of the changes to the scheduling of combination medicines containing codeine and it outlines the impacts of the changes on patients, pharmacists, pharmacy staff and other health professionals.
Further information for pharmacists, including factsheets, conversation tips, case studies and education resources can be found on the TGA’s codeine hub website.
The Codeine Hub on the TGA website contains information about the changes, some of which include where to get advice, how codeine affects the body and answers to frequently asked questions. You can access this information here in the resources for community section. If you would like medical advice, you can speak to a pharmacist or GP.
If you are concerned that you may have a codeine dependency you can speak to a pharmacist or GP. More information about the harms of codeine.
Answers to frequently asked questions such as those below and more can be accessed here.
- What is changing and when?
- What medicines will be affected?
- I suffer from chronic pain, what should I do?
local counselling services
Northern Sydney Local Health District provide counselling services across a variety of locations in Northern Sydney
SDECC – AOD Intensive Support Program
Non-residential day rehabilitation, including individual counselling, care coordination, group programs and intensive outreach for people aged 14-25 years Services are available in Chatswood and Manly.
To access the program call 9977 0711.
Odyssey House Community Services
Non-residential rehabilitation for adults over 18 years old, including individual and group counselling, support to family members of people who have an addiction. Services available in Chatswood and Manly. To access the program call 1800 397 739.
Odyssey House Community Services – Drug & Alcohol Counselling
Non-residential day rehabilitation for Aboriginal and Torres Strait Islander adults over 18 years old, including individual and group counselling, support to family members of people who have an addiction. Services available in Chatswood and Manly. To access the program call 1800 397 739.
ACON – Substance Support Counselling
Face-to-face in Surry Hills and remote access program (Skype or telephone) providing intensive, structured interventions within a harm reduction model to Lesbian, Gay, Transgender and Intersex people with alcohol and other drug misuse issues. Up to 12 sessions with the ability to extend. To access the program call 1800 063 060.