Pain experts call for codeine-free pain relief

Australia’s top pain medicine body is urging patients to start considering alternative pain relief to codeine ahead of the ban on over-the-counter sales of the drug early next year.

Dr Chris Hayes, Dean of the Faculty of Pain Medicine (FPM), said the combination of anti-inflammatory drugs with paracetamol provides better pain relief for many types of acute pain without the risk of codeine addiction. In addition codeine has been found to be ineffective for chronic pain.
From February 2018 codeine will only be available at pharmacies with a prescription. Low-dose over-the-counter codeine, which is a weak opioid, has been found to be ineffective for pain relief and highly addictive. When codeine is combined with paracetamol or anti-inflammatory drugs overdose can lead to serious liver damage, stomach ulcerations, renal failure and even death.
Dr Hayes said patients and consumers still had six months to prepare for the change, which was announced by the Therapeutic Goods Administration in 2017 and he hoped this would give patients time to consider alternatives.
“Patients do have a choice such as over-the-counter anti-inflammatory medications and paracetamol which are alternative options to codeine to relieve acute pain,’’ he explained.
“But pain relief isn’t just about medication alone. Neuroscience research has shown that pain is primarily an interpretation of the brain and therefore it is possible to retrain the nervous system with a view to pain reduction. It’s about self-managing your condition through thinking well, eating well, keeping physically active and making sure you stay socially connected with friends and family. This can change the way the nervous system responds.
“All these strategies combined can have the power to reduce pain over time.”
Dr Hayes said it was important that patients talk with their GPs and pain physicians about how to manage pain and how the codeine restrictions may affect them.
FPM was one of several organisations that made submissions to the TGA inquiry into the issue. FPM argued that the widespread availability of codeine in pharmacies was a serious public health concern with rising numbers of people misusing the drug.
The FPM and other organisations have recently reiterated their support to the TGA for the ban which effectively reschedules codeine from a schedule 3 classification ─ which means it can be sold over-the-counter in pharmacies ─ to schedule 4 where it can only be supplied with a doctor’s prescription.
About FPM
The Faculty of Pain Medicine is a world-leading professional organisation for pain specialists that sets standards in pain medicine and is responsible for education and training in the discipline in Australia and New Zealand. Pain medicine is multidisciplinary, recognising that the management of severe pain requires the skills of more than one area of medicine.
Chronic pain affects about one in five people in Australia and New Zealand. Specialists also manage acute pain (post-operative, post-trauma, acute episodes of pain in medical conditions) and cancer pain. For more information, please see here.
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