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Changes to patient access to low dose codeine

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Codeine to be only available on prescription

As of 1st February 2018 any medicines containing codeine will only be available on prescription, where previously low dose codeine preparations (<30mg) were available over-the-counter at a pharmacy. It has come in a number of painkilling preparations such as combination with paracetamol (panadeine) or ibuprofen (nurofen plus).

Codeine is an ‘opioid’ painkiller that is related to morphine. Whilst codeine in low doses can provide effective short term pain relief, evidence has suggested that such drugs offer very little additional benefit when compared to similar medicines without codeine. The use of such medicines however, is associated with high health risks. These downsides include:

  • Side effects – severe constipation, headaches and nausea
  • Tolerance – requiring higher doses to gain the same painkilling effect
  • Withdrawal effects and dependence – requiring the drug to just get through the day rather than for painkilling benefits.
  • Toxicity – Taking higher doses can damage the body and even lead to death.

Some people may have been treating long term pain themselves with over-the-counter codeine in preference to consulting with a practitioner and/or unwittingly become dependent on these medications having relatively easily gained access to them. These people will be required to be assessed by a practitioner to gain a prescription for these drugs due to the policy change in February.

Here at EMC we understand the difficulties this places people in, and we wish to assist by assessing people, their pain management and guide them appropriately. Given the drawbacks of long term codeine our skilled practitioners may suggest reducing codeine dosages and potentially provide alternative painkilling strategies.

In keeping with our existing opiate pain medicine prescribing policy, no practitioner here at EMC will prescribe codeine on a first consultation with a patient.

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