A Port Macquarie pharmacist says rescheduling of low-dose, over-the-counter codeine-containing medicines from February 1 will have major impacts on the community.
Judy Plunkett, a member of the Pharmacy Guild of NSW, says the Therapeutic Goods Administration's decision will see community members requiring a doctor's prescription to receive some codeine-based medicines.
The medicines affected include, paracetamol + codeine 500mg + <15mg which includes Panadeine, Panadeine Extra and Mersyndol; Ibuprofen + codeine 200mg + <15mg which includes Nurofen Plus and Panafen Plus; Asprin + codeine 300mg + <15mg which includes Aspalgin, Codis Disprin Forte; and cough and cold medicines, which includes Codral Original Cold and Flu, Demazin day and night cold and flu.
"February 1 will mean congestion at doctors' surgeries and a crowded A&E (hospital accident and emergency),” Ms Plunkett said.
"This will see upward pressure on Medicare, increased costs to patients where your doctor does not bulk bill and more of the so-called doctor and pharmacy shopping.
"In some rural and regional areas it will actually lead to people suffering unnecessary pain because they won't be able to access a doctor and therefore any treatment stronger than paracetamol and ibuprofen at all. It will be distressing for both patients and pharmacists."
Ms Plunkett said pharmacists had been 'for many, many years' part of the health system where they safely treated patients for short term acute pain.
From February 1, she says, that will not be the case.
Ms Plunkett was also critical of the level of misinformation currently being circulated where pharmacists are being discredited for their stance.
"I've been told that pharmacists oppose this move because it will cost them money," she said. "On the contrary, we are likely to get more money because the patient will still require the prescription to be filled out.
"The other myth is the number of deaths associated with over-the-counter codeine-containing medicines. It is minimal."
That means that from February 1 there will be no recording and monitoring of use anywhere. How does that help with concerns about over-use?Judy Plunkett
The guild's use of the MedsASSIST program which allows some 70 percent of the state's pharmacists real time recording and monitoring of patient use of codeine medicines will also cease on February 1.
"That means that from February 1 there will be no recording and monitoring of use anywhere. How does that help with concerns about over-use?, she added.
Port Macquarie MP Leslie Williams says the state government, and particularly The Nationals, realise the impact the decision will have on regional and rural communities.
"Compared to metropolitan areas, we have limited access to GPs, particularly after hours.
"It may also have an impact on A&E where more people will go when they require scripts for acute pain."
"As a government, we will continue to advocate to the federal government the need to reconsider and understand the impacts this decision will have on regional and rural areas."
Mrs Williams said, as the local member, she will continue to voice her concerns on the matter.
Federal MP, Luke Hartsuyker said he supported the changes based on the lengthy consultation period and the raft of supporting organisations.
"This measure was recommended by all chief health officers and chief pharmacists," he said.
"The supporting organisations include, the AMA, Royal College of General Practitioners, Royal Australian College of Physicians, Pain Australia, The Australia New Zealand College of Anaesthetists, The Australian College of Rural and Remove Medicine, Rural Doctors' Association of Australia and the Consumer Health Forum of Australia.
"I am surprised by the gap between what the pharamcists and the guild are saying and the likes of the AMA.
"But I will listen with keen interest to what the guild and pharmacists are saying."
Australia's chief medical officer, Professor Brendan Murphy, says the best medical advice and research shows that codeine is no better for pain than other over the counter medicines.
He said the decision was 'good scientific evidence'.
“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," he said.
For more complex acute or chronic pain medical input is warranted and so it is essential that a person sees a GP.Professor Brendan Murphy
"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.
“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."
The vice president of the AMA, Dr Tony Bartone, says the decision is about addressing an ineffective option and provide a better management practice for patients’ pain.
“This is not about trying to create extra work for doctors,” he said. “We want an effective, reliable and robust management of patients’ pain.
“If they are taking it (codeine-based products) and it is not assisting them with their pain, it is quite likely they could become dependent.”
He said the AMA was looking to education patients to ensure an appropriate management plan was in place for patients prior to February 1.