Doctors’ groups are urging the states not to opt out of new rules making codeine-containing analgesics available by prescription only.

As reported by the limbic this month, following intense lobbying by the Pharmacy Guild of Australia, state and territory health ministers called on the federal government to review the TGA’s decision to upschedule OTC codeine (see here).

The guild has been lobbying hard for exemptions to the TGA rule which comes into force February next year, putting forward an alternative model to allow pharmacists to sell codeine without a prescription in certain scenarios.

A spokesperson for the TGA said each state and territory is empowered to implement such an exemption.

But this model “carries a serious risk of increased harms and potentially preventable deaths and thus cannot be supported by the medical community or consumer advocates,”  the Royal Australasian College of Physicians wrote in a letter to NSW Health Minister Brad Hazzard this week.

The letter was co-signed by the heads of the Royal Australian College of General Practitioners, Rural Doctors Association of Australia, Pain Australia and Consumers Health Forum of Australia.

The groups argue that the Guild’s advocacy “sends misleading and confusing messages” to the public regarding the effectiveness and safety of OTC codeine and could have “serious adverse impacts” on the clinical regulatory interface which safeguards the public.

They point to the TGA review of evidence which underpinning its upscheduling decision.

The review found codeine is not an effective for treatment of chronic long-term pain, is associated with death, toxicity and dependence, and that OTC combination formulas containing codeine are less effective than some other OTC analgesics.

“We would be seriously concerned if the Guild’s lobbying of state and territory governments included any suggestion that individual jurisdictions create exemptions that would be tantamount to walking away from nationally consistent regulation of medicines in this country,” the letter said.

“The success of the national strategy to reschedule codeine rests on all key stakeholders, including state and territory governments and peak bodies representing consumers, pharmacists and medical professionals, engaging and supporting this process.”