Low dose codeine ineffective for most pain relief

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The best medical advice and research shows that codeine is no better for pain than other over the counter medicines, Australia’s Chief Medical Officer, Professor Brendan Murphy, said on January 12, 2018.

“In fact, according to research by the Faculty of Pain Medicine, paracetamol and anti-inflammatory medications, alone or in combination, are adequate over the counter (OTC) preparations for most types of acute pain occurring in a community setting. For more complex acute or chronic pain medical input is warranted and so it is essential that a person sees a GP. 

“There are numerous studies that show that codeine is not the miracle pain relief drug that people think it is and there is compelling evidence of harm caused by overuse and abuse of over the counter codeine-containing medicines. This highlights that stockpiling over the counter codeine is simply a waste of time.”

Professor Murphy said there is clear evidence of significant misuse of codeine in Australia with almost half a million people incorrectly using painkillers containing codeine in Australia it is a very real and increasing problem. 

“The best current data indicates that low dose codeine is no better than – and perhaps not as effective as – combination paracetamol and ibuprofen for relief of acute pain,” Professor Murphy said.

“The decision to make codeine-containing medicines prescription from February 1 is in line with 26 other countries which have done the same thing based on good scientific evidence. 

“This decision was made following the unanimous recommendation of the Advisory Committees on Medicines Scheduling and Advisory Committee on Safety of Medicines. The TGA has also recently consulted the Chief Pharmacists and Chief Health Officers in the States and Territories, who have all confirmed that they continue to support the rescheduling of codeine containing products and its implementation date.”

Professor Murphy said going to the doctor to discuss pain relief enables better, more modern approaches to be used for treatment of pain such as from migraine or period pain. It also gives people the opportunity to have any codeine drug dependency picked up, discussed in a private setting and treated appropriately. 

“There is widespread support from medical organisations about this change including from the Faculty of Pain Medicine, AMA, RACGP and Rural Doctors and from the main consumers organisations such as Painaustralia, the Consumer Health Forum and the NPS MedicineWise.

“This decision is about saving lives,” Professor Murphy said.

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