Most codeine users are not being advised of alternative treatments, study shows06 Sep 2018
The majority of people seeking codeine from their doctor are not being offered or advised about alternatives, finds a new study.
The survey, commissioned by AFT Pharmaceuticals, also showed that almost all of those who have been to doctor for a codeine prescription are still receiving codeine in some form.
About 65% of those surveyed said they were receiving the same codeine product as they were taking before and 33% said they were taking a different or stronger codeine-based drug.
Fewer people have switched to alternatives than anticipated.
About 28 percent have gone to their doctor in search of continued codeine, while 18 percent had stockpiled over-the-counter codeine products before the scheduling change.
They were seeking alternative over-the-counter pain relief or visiting their doctor for codeine on prescription over the coming months.
The survey was of over 200 people who had been codeine buyers before new restriction were introduced in February.
Significant risks and dangers
A leading pharmacologist says the survey results raises questions regarding whether post-rescheduling Australia is moving in the right direction when it comes to the appropriate use of opioids for pain. It also indicates that prescribers could benefit from more support in this area.
“Long-term pain sufferers were less likely to have switched to a non-codeine drug,” says pharmacologist Dr Hartley Atkinson, the CEO of AFT Pharmaceuticals.
“It’s troubling because in such people there’s little evidence for effectiveness and a higher risk of dependence and side effects,” Dr Atkinson said.
“Consumers need to be aware of the significant risks and dangers. It begs the question, given the reasons for rescheduling OTC analgesics, are consumers getting appropriate advice about their use of pain relief?”
Codeine users seeking trusted advice
Dr Atkinson says people are looking for trusted advice about codeine alternatives for their pain relief, whether they are doing their own research online, going to their pharmacy or even their supermarket.
“If going to see their GP it’s important for consumers to ask about non-opioid alternatives, the efficacy of codeine and the risks in using it,” he says.
“However, not everyone wants or needs to pay for a doctor’s visit. It’s important to remember that pharmacies offer effective non-opioid alternatives for short-term, acute pain that most consumers are seeking relief from.”
In the survey results, pharmacists and pharmacy staff were shown to be the most influential combined source of professional advice for people who had switched to non-codeine alternatives and the largest proportion of respondents (34%) have sought an alternative from a pharmacy.
“They have a very important role to play in educating consumers and are a good and accessible source of professional advice for consumers,” Dr Atkinson says.
Key survey results
- The primary factors for consumers in choosing pain relief are strength and speed (overall efficacy)
- 18% of those surveyed have stockpiled codeine and will face a decision as to what to do about alternatives in coming months
- 28% of patients are going to doctors for codeine despite the reason for rescheduling being limited efficacy of codeine and potential for harm. Two thirds of these patients are getting the same codeine pain relief they were taking previously and one third are getting a different or stronger form of codeine for pain relief from their doctor
- 80% said their doctor did not suggest an alternative pain killer that does not contain codeine
- 67% of those surveyed only required pain relief for short term pain like headache and period pain, but doctors continue to provide codeine. This was despite primary reasons for rescheduling including the limited efficacy of codeine and the potential for harm and dependence from its use.