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OTC codeine in combination upscheduling unnecessary

Consumer healthcare products industry body, the New Zealand Self-Medication Industry (SMI), says the decision by Medsafe’s Medicines Classification Committee (MCC) to make over-the-counter (OTC) codeine in combination painkillers prescription-only in New Zealand from January 2020 is disappointing and unnecessary.

The Committee has also recommended that from January 2020 medicines containing codeine as the only active ingredient should be reclassified from prescription to restricted medicine i.e. available in small packs from a pharmacist following consultation and recording.

“We are disappointed that the MCC did not take the opportunity to encourage better recording of sales OTC and instead has pushed all codeine-in-combination products to prescription-only where anecdotal evidence and earlier research suggests the bulk of abused codeine is procured,” says SMI executive director, Scott Milne.

Mr Milne says the decision means a valuable opportunity to develop a real-time recording system for codeine purchases proposed by SMI and the Pharmacy Guild may have been lost.

“Pharmacists here are required by law to determine whether it is appropriate to supply over-the-counter painkillers containing codeine and a move to prescription-only disregards the expertise of pharmacists and their important role in the frontline of primary care.

“The current scheduling of these medicines means consumers must seek counselling from a pharmacist during the purchase of codeine-containing products and the purchase must be recorded. However, this is currently not done in real time. A real time recording system would severely inhibit the opportunity for opiate abusers to shop around for codeine-containing product. Pharmacists have the professional expertise to address any questions consumers may have about these products,” he says.

Mr Milne adds: “The use of non-prescription medicines containing codeine is safe when used according to label instructions. These medicines are intended strictly for short-term use.

“The vast majority of NZ consumers use OTC codeine-containing products appropriately and there is little evidence of misuse of codeine-containing products in New Zealand. SMI had therefore advocated to retain the current classification of OTC codeine-containing products.

“SMI strongly supports the appropriate and responsible use of all medicines and a prescription-only classification is no guarantee against misuse or abuse of a medicine.

“We are concerned that further restricting access to these medicines will have unintended consequences for consumers, who will be required to visit a GP or emergency department to access medicines for minor, self-limiting conditions instead of being able to get them from a pharmacy. It will also increase the workload of doctors and create greater inefficiencies and additional cost in an already over-strained primary health system.”

Mr Milne says that when taking any medicine, it is important that consumers read the label carefully, including the warning statements on the pack, and only take the medicines as directed.

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