Need for smarter, not stricter, regulation of codeine sales

The Therapeutic Goods Administration (TGA) announced in December 2016 that products containing codeine would be available only to purchase with a prescription, effective from February 1, 2018.

The ATA identifies several problems with the status quo whereby codeine/ibuprofen and codeine/paracetamol are prescription drugs. It means longer waiting hours in clinics and more frequent consultations with GPs for busy Australians. Additionally, it will create a backlog in processing prescriptions, leading to more pressure on pharmacists, dispensary technicians and pharmacy assistants as well as longer waiting times for patients in serious pain.

Pharmacists are the only health professionals in Australia who do not charge for their time. This is why pharmacists like Mario Tascone are outraged over the decision, noting that pharmacists are forced to spend more time at the dispensary counter and less time counselling patients.

There's no denying that some Australians do abuse codeine, although the numbers would be paltry when placed next to the abuse and addiction rates for alcohol, cigarettes, harder pharmaceuticals and many other products even IF over-the-counter sales were legalised.

However, if the government insists on a regulatory solution as a way to tackle the problem then there is an easier, more practical way which would minimise inconvenience to both pharmacists and patients.

Bring back the MedsAssist program.

MedsAssist was introduced in mid-2016 as a convenient and fast way to record the sale of all Schedule 3 codeine products. Pharmacists, assistants and technicians would use the programs to record each customer's product purchase and could display their history with the sale requiring some form of photo ID. In lieu of prescriptions, chemists should be responsible for recording every sale of codeine on MedsAssist.

There is already a similar program in place used to record the sale of pseudoephedrine called Project STOP, developed by the Pharmacy Guild of Australia. It involves a similar process of requiring photo ID to process the sale of Schedule 3 drugs containing the ingredient, and is a quick and efficient tool for recoring a patient's information and medical history.

Putting codeine products on prescription is an insult to pharmacists, dispensary technicians and trained pharmacy assistants who, through experience and training alone, can determine whether or not the sale of Schedule 3 drugs is appropriate in particular circumstances. The standard procedure is that a pharmacy assistant or dispensary technician asks the patient questions about who is using the medication, whether or not they are allergic to any ingredients, if they take any other medicines and whether or not they suffer from conditions such as high blood pressure or asthma. They then report the answers to the pharmacist before handing the product to the customer.

Schedule 3 codeine products should be available over-the-counter at pharmacies. The status quo conflates safety with unnecessary bureaucratic interruption. The government's health strategies should be helping not hindering, the prompt receipt of quality advice, medication and pharmacist counselling services by the patients.