Addiction fears trigger bid to control painkillers

Photo / Glenn Jeffrey

Public access to a widely-used class of painkillers containing codeine is likely to be restricted within months because of what is said to be an increase in the rate of addiction to the opium-linked drug.

The recommendations of a Government advisory committee on the painkillers mirror the controls on pseudoephedrine, an ingredient in many cough and cold medicines, and also a precursor of the illegal drug P.

As part of its "plan to fight P", the Government is making pseudoephedrine a prescription-only medicine, blocking its illegal purchase from pharmacies to make P.

Medicines regulator Medsafe said yesterday a Health Ministry decision was expected within weeks on proposals that the number of combined codeine painkiller tablets in each packet be reduced, and that users be warned they are addictive.

The moves will mean pharmaceutical companies have all but lost their battle to avoid greater restrictions on consumers' access to the medicines which include market leader Nurofen Plus, and Panadeine.

New Zealanders spend more than $13 million a year on the combined codeine painkillers.

Medsafe said last year it favoured tighter restrictions on the combinations of paracetamol or ibuprofen with codeine, an addictive narcotic.

Codeine was the base for the illegal manufacture of "homebake" heroin.

And prolonged and excessive consumption of medicines such as Nurofen Plus created the risk of stomach ulcers from the ibuprofen component.

The Government's medicines classification committee wants pack sizes cut from up to eight days' supply to a maximum of five days, stocks put behind the counter, sales restricted to qualified pharmacists, and warning labels on addiction and not using the drugs for more than three days unless on medical advice.

Those wanting more than five days' supply would need a doctor's prescription.

Cough and cold medicines containing codeine are not subject to the proposals, but the committee wants Medsafe to write to pharmacist organisations urging that these medicines also be put behind the counter because of the risk addicts could change to products less tightly controlled.

Dr Stewart Jessamine, the committee's chairman and the head of Medsafe, said the committee's moves were in line with those in Australia and Britain, and reflected increasing rates of codeine addiction.

"It's something that has always been there, but we have become more aware of it in recent times," he said.

The committee's minutes say Auckland's Community Alcohol and Drug Services each week see one new client who is taking excessive amounts of over-the-counter medicines containing codeine. Some were seeking help because of complications such as gastric bleeding or anaemia.

The Herald on Sunday last year reported the case of a addict who swallowed nearly 100 Nurofen Plus tablets a day. It took her at least three attempts to wean herself off the pills, which she said caused stomach aches, constipation and other ills - and cost her $10,000 at pharmacies.

But the Self-Medication Industry, representing suppliers, said she was in a tiny minority, and the proposed changes would impose unnecessary restrictions on the responsible majority of users.

"These medicines play an important role in relieving strong pain and limitations on their availability will be an enormous inconvenience to thousands of responsible users," said the industry group's executive director, Tim Roper.

THE RULES
* Painkillers like Nurofen Plus and Panadeine can be displayed on pharmacy shelves
* Pack can contain up to eight days' supply
* Can be sold by any pharmacy worker

A Government committee has recommended:
* They are put out of public view
* Packs limited to five days' supply
* Can be sold by a pharmacist only
* Label warning: "Codeine is an addictive substance"