Pharmacists Receive Scripts for ‘Hundreds’ of Addictive Pain Pills
One pharmacy has received a prescription for more than 2000 addictive painkiller tablets and many others across the country have seen orders for hundreds in the past few days.
Pharmacists say it’s a trend which appears to undermine Australia’s new ban on over-the-counter codeine that came into effect on Thursday.
Melbourne pharmacist Jarrod McMaugh said he has received repeating scripts totalling 10 boxes of Panadeine Extra containing 240 pills, even though it is advised that patients only take up to a maximum of eight tablets a day, for no more than three days.
Mr McMaugh, who is the Pharmaceutical Society’s Victorian vice-president, said he didn’t fill those scripts. He’s also aware, he says, of more extreme examples from across the country.
In Queensland, he said a pharmacist had received a script for 20 boxes of prescription medication Mersyndol Forte (a combination of paracetamol, codeine and a sedating antihistamine) with five repeats.
This would have given the patient access to 2400 tablets if all the scripts had been filled, it’s claimed, but the pharmacist who received the request refused to dispense the medication.
Until this week, a number of low-dose codeine products, including Panadeine, Nurofen Plus and Mersyndol, were available over the counter.
It was decided to make all codeine medication prescription-only, after evidence came to light that people were accidentally becoming addicted to the painkiller pills. There have also been claims that about 100 Australians die each year from misuse.
Mr McMaugh said while most GPs were doing the right thing when it came to prescribing drugs, a “small proportion” of doctors were not.
He said he called all the GPs behind the “inappropriate” scripts, discovering one had made a typing error, but he reported other doctors to the Australian Health Practitioner Regulation Agency.
Bastian Seidel, president of the Royal Australian College of General Practitioners, said it was important to understand the context behind the prescribing.
He said while it was not ideal, there could be genuine reasons why a GP would prescribe codeine at rates higher than the recommended dose.
For example, Dr Seidel said he had just provided a prescription of Panadeine Forte (codeine and paracetamol) to one of his patients after they exhausted all other options, including psychology, acupuncture, movement therapy and relaxation techniques.
He said the patient had severe pain and codeine was the only treatment so far that provided some pain relief with fewer side effects.
“She knows it’s not ideal, I know it’s not ideal, but it is the best compromise for her to have under supervision,” Dr Seidel said.
“Hopefully we are going to find some solution that is better for her in the future, but for the moment that’s just about what works.”
By the time the new codeine rules came into effect on Thursday, most people had time to prepare for the change following discussions with their pharmacist or GP.
Instead, pharmacist Mark Tsitonakis at the Oakleigh Central Amcal Pharmacy in Melbourne said they saw a spike in requests for codeine painkillers on Wednesday, the day before the rule change.
“Without a doubt people were trying to stockpile. A lot of people were quite honest about it, saying they were trying to get as much as they could,” Mr Tsitonakis said.
But the pharmacy, like most others around the country, had exhausted most of its low-dose codeine supplies weeks before.
“We did offer other options,” he said.
“Some people were willing to have a chat, others were on the move because they were having a busy day.”
Mr Tsitonakis said he had not seen an increase in GPs prescribing codeine, but if he had any concerns about a script he would always ring the doctor and ask for some more information before dispensing.