Background
Codeine is one of the most commonly used
opioids worldwide and is available in different formulations, often combined with other simple
analgesics. There is a growing concern of the potential harms associated with
codeine misuse in the Australian community, and for this reason
codeine containing
analgesics have been upscheduled in Australia to 'prescription only medicines' from February 2018. There is currently limited knowledge on the views of Australian adults experiencing
pain symptoms on this
codeine restriction, and whether this change has impacted their ability to adequately manage their
pain. Objective To investigate the views of adults experiencing
pain on the 2018
codeine upscheduling in Australia. Setting Adults experiencing
pain symptoms, predominantly recruited from Victoria, Australia. Method A descriptive cross-sectional study was conducted using a pre-tested customised anonymous self-administered questionnaire between January and March 2019. To capture a broad range of demographics, participants were recruited from ten Victorian community pharmacies across metropolitan Melbourne, Australia. Main outcome measure Opinions of Australian adults experiencing
pain to targeted questions regarding the 2018
codeine upscheduling, including perceived advantages and disadvantages. Results A total of 120 participants completed the questionnaire. Sixty-two (52%) participants agreed/strongly agreed that
codeine was helpful in alleviating
pain symptoms before a prescription was required; while 43% of participants felt the
codeine restriction has made it more difficult to manage their
pain, with 33% unsure. Participants who were in favour of the
codeine upscheduling believed that they are now more encouraged to consult healthcare professionals and make better use of the
pain management services made available to them in the Australian community; however some now question the value of pharmacists in this context, given that there is now a reduced array of
analgesic medicines available at pharmacies without a prescription. Conclusion This study showed there are mixed views, with some participants being unsure or not in favour of the
codeine upscheduling, particularly based on qualitative responses. There is also opportunity in this space for healthcare providers to extend beyond standard practice and offer alternative
pain management advice and support now that
codeine is no longer available in Australian pharmacies without a prescription.