Codeine can now only be bought with a script. Photo / 123RF
Anna Denby has spent months preparing for this week's codeine ban.
Codeine medication will no longer be sold over the counter from pharmacies or shops and patients need to go to a GP for a prescription.
The move, recommended by the Therapeutic Goods Administration, is an attempt to curb the small percentage of Australia's one million codeine users who abuse the drug, reports news.com.au.
Codeine is highly addictive and can cause hospitalisation, organ damage and even death if misused. At least 100 deaths a year in Australia are directly related to codeine.
But Anna, 33, has endometriosis, a condition where tissue that normally lines the uterus grows outside the uterus, causing pain and often infertility. She has two to three pain attacks a month.
"I have found that Nurofen Plus [a codeine drug] allows me to nip my endo pain in the bud so I can stay at work and keep my job, see my friends and not be in pain and not have to take heavier medication," Anna, from Sydney's Bondi, told news.com.au.
"If I'm at work and I start to get that familiar niggle in my pelvis, I'll take two tablets and then if it gets worse another two. I can go weeks without pain but then suddenly I'll have a pain attack — it will overwhelm me and I'll need to take something," Anna said.
Since the codeine ban was first announced late last year, Anna has been "stocking up" and "rationing" her codeine tablets because she's been unable to find a GP in her local area who will write her a prescription.
She has joined the three-month waiting list at a pain management clinic and has an appointment scheduled for later this month.
"When I went to my GP, they had signs in the waiting area saying, 'We can't prescribe opioids,'" Anna said.
"I went to three different GPs in a week and they all said, 'What we should be doing is referring you to a pain management clinic and getting you on a pain management plan.'"
She says the ban does not take into consideration the needs of chronic pain sufferers, particularly women.
"A blanket ban isn't the best course of action. I would like to know how many women with endometriosis were involved in these [political] discussions," she said.
Teena Hantke, 41, has lived with endometriosis for 20 years, as well as fibromyalgia syndrome, a chronic pain condition.
She takes a range of pain medication but also takes codeine regularly, as she has undergone 44 surgeries over the past two decades.
"When you have complex health issues and so many doctor's appointments — GPs, specialists, physios, chiropractors — having to try and squeeze in additional doctor's appointments to get a prescription for codeine for a migraine or post-surgery pain is unrealistic," Teena, from Adelaide, told news.com.au.
"It's also the cost of having to go to the GP to get a script, when my out-of-pocket expenses for my medical stuff can be between $5000 and $15,000. It just adds on a whole other layer of anxiety, stress and financial impact," she said.
Pain can strike at any time, but getting an appointment to get a codeine script can be difficult to achieve at a moment's notice.
"When you have endometriosis, you can't just go to any GP because there is this culture of 'it's all in your head'. It takes women with endo on average seven to 10 years to be diagnosed.
"It's taken me years to find a good GP, but she's so good that it takes three weeks to get an appointment with her. Even if I see another doctor in the same clinic, they still don't understand. The difference between doctors can be enormous.
"You're being made to feel like you're a drug addict when you're suffering and just trying to get through the day."
According to new research from Amcal Pharmacy, 80 per cent of Australians suffer from pain. Two-thirds of those surveyed encounter sceptisim from family, friends and colleagues and 28 per cent struggle to convince medical professionals their pain is real. Of those surveyed, 26 per cent said they prefer to treat their pain with codeine-based painkillers.
Pharmacy Guild of Australia president Trent Twomey said codeine-based products had been selling out in his pharmacies since December.
Mr Twomey described the upscheduling of codeine as a "blunt instrument".
"What the evidence shows is that two per cent of users are abusers and these people need to be helped," he told The Cairns Post.
"They need to be referred on to proper treatment and pharmacies, general practitioners and the local hospital — they play a role in helping these people.
"The problem is, the 98 per cent of other people that are using (codeine) legitimately and appropriately now have to go through another regulatory hurdle to be able to access that product."
Federal Health Minister Greg Hunt insists up to 100 lives a year can be saved when codeine is taken off store shelves.
Mr Hunt says codeine is addictive and dangerous and Australia's over-the-counter ban will match others in the US and UK. A prescription is required for codeine products in some European countries including Austria, Belgium, Germany and Italy, as well as Japan and the United Arab Emirates.
"We know that there are over half a million Australians with some form of codeine addiction," he told ABC radio on Tuesday.
"It would be almost unthinkable for any responsible government to ignore the unanimous advice of medical authorities."
The minister pointed to a greater availability of paracetamol and ibuprofen combination medications and talked up the nation's high bulk billing rates when quizzed about the frustration and cost of having to see a doctor for a script.