Private hospitals provide codeine detox patient care

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New laws limiting access to over-the-counter codeine medications will bring an increase in people seeking help to break their addiction to the drug, says Brisbane Private Hospital psychiatrist David Storor.

From Thursday 1 February 2018, all medicines containing the opium derivative require a doctor’s prescription due to new government legislation targeting nationwide addiction problems.

Dr Storor said regular use of codeine-based painkillers for recurrent headaches and back pain can escalate consumption as tolerance builds over time “until people are taking 30 to 60 or more tablets a day”.

The Federal Government’s action to curb codeine use is supported, but will mean more Australians need care to help beat their addiction, he said.

Codeine has a “high risk” of dependence, he said, while the analgesic drugs it is usually combined with – such as paracetamol and ibuprofen – can damage the liver, kidneys and gastrointestinal system at such high dosage.

“The risk of abuse and dependence on these codeine-containing medications is heightened in people who are suffering from stress, anxiety and depression,” Dr Storor said. “In much the same way as people come to rely on alcohol to de-stress, people can develop a habit on compound codeine analgesics.”

The Federal Government is spending more than $1 million to help health practitioners and consumers adjust to the new laws.

It cited studies showing that over-the-counter codeine medications are a factor in nearly 100 deaths every year, and that they offer little additional benefit when compared to similar non-opioid pain-relief options.

Health Minister Greg Hunt said $15 million will also be invested in a real-time monitoring program for all prescription drugs.

Dr Storor backed Mr Hunt’s assertion that many people who misuse painkillers had done so with over-the-counter codeine products, citing patient data from Brisbane Private’s Damascus Alcohol and Prescription Drug service.

“From 2010, approximately one-third to one half of all people presenting for prescription opioid addiction are dependent on over-the-counter codeine medication,” he said.

With codeine products now harder to obtain, Dr Storor said long-term users – “thousands of Australians” – will need help detoxing at facilities such as Brisbane Private’s Damascus Health Services.

“Treatment of codeine-dependent people involves a medicated detox in a supported inpatient environment, counselling and the development of alternate strategies for managing stress, anxiety and depression or chronic pain.

“Some people will need to be stabilised on alternate longer-acting opioid analgesia in the short-term,” he said.

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