Panadeine shortage pushing patients onto stronger, addictive codeine painkillers, pharmacists warn
New laws to combat fatal codeine overdoses are actually pushing patients onto stronger doses of the potentially addictive drug, pharmacists say.
GlaxoSmithKline stopped making Australia’s leading codeine-based painkiller, Panadeine, after new laws were introduced in February requiring customers to get a doctor’s prescription to buy the drug.
That has left a shortage of low-dose codeine products across Australia.
“We have seen instances where, because patients can’t get the low-dose containing product that they were on, they’re actually now being prescribed high-dose codeine products that are available,” said Anthony Tassone, the Victorian president of the Pharmacy Guild.
“It’s important that there is some careful consideration if that’s appropriate for the patient.”
Rob Anderson from the health advocacy group, Move (formerly Arthritis Australia) said he is more worried about the effect the shortage is having on the people the new codeine laws were aimed at — those hiding their misuse of codeine from authorities.
“It’s what we’re not hearing that’s more the concern,” Mr Anderson said.
“Whether there’s an increase in alcohol dependency or drug dependency, whether or not there’s the sourcing of the dark web for codeine or other illicit products.
“That’s got its own concerns in relation to not knowing what’s in those pills. These are people that haven’t had in the main a whole lot of support.”
‘Can’t survive a day’ without it
Wendy Benson has gone into remission twice from a rare form of non-Hodgkin’s lymphoma.
During chemotherapy treatment, she relied on codeine to get through the day.
“I know that if it comes around again, the pain will be so bad and if that product wasn’t available to me, I don’t know what I would do,” she said.
Ms Benson has a prescription for a higher dosage of codeine, but so far she has not needed it.
The people she encounters through her work with the Australian Patients Association are not as lucky.
“There are people out there who can’t survive a day without taking Panadeine to keep getting them through,” Mrs Benson said.
“And if they wait too long, then it’s too late, so they’re in major, major pain.”
Ms Benson said she could understand why the restrictions were put in place, but questioned what would happen if people who need it could not get it.
“What are they going to do and how addicted are they going to get to other products?” she said.
Data from the Coroners Court of Victoria revealed that, in 2016, prescription drug overdoses killed 303 people.
That is more than the 217 people who died from illegal drugs and the 252 people who died in the road toll.
The Federal Government tightened restrictions on the use of codeine to try to curb the problem.
“It is frustrating for patients who’ve tried to do the right thing, to see their doctor, gain a prescription, sometimes have to pay a fee for the consult and then arrive at a pharmacy only to be told it’s not available,” Mr Tassone said.
“Unfortunately that has been beyond the control of pharmacies.”
Doctors said the shortage had provided a valuable opportunity to wean patients off medications.
“There are a lot of other things that we can do that don’t just involve tablets,” said Dr Abhishek Verma from the Royal College of General Practitioners.
“Things like exercise or physiotherapy, massage, heat packs, icepacks.
“It’s actually providing a very valuable stimulus for them to have a chat to their doctors about [whether or not] that medication is appropriate for them, for their pain condition.”
A spokeswoman for the Federal Department of Health said assistance was being offered to people suffering pain.
She said a $20-million trial is being conducted to help patients and pharmacists work together to manage chronic pain, and patients should consult a healthcare professional about whether they need codeine.
Other manufacturers of low-dose codeine painkillers have been ramping up production since GlaxoSmithKine’s withdrawal of the drug.
The Pharmacy Guild said it expected alternative supplies would fill the void by mid-May.