PHARMACIST and Heritage Hotel Dorrigo owner Peter Feros is concerned that from February 1, Bellingen Shire residents will lose convenient, over-the-counter access to strong pain relief.
Mr Feros says that when medicines containing codeine, such as Panadeine, Nurofen Plus and Mersyndol, become prescription-only, people with acute pain will either have to wait for a doctor’s appointment or attend a hospital emergency department to find doctors and painkillers at the one site.
His own experience of having extreme toothache last year has made him reflect on how the upcoming change in regulation might affect members of the local community.
“On April 24 last year I had a stroke while I was on holiday in the UK,” Mr Feros said. “After treatment and a return to Australia, two months later I woke on a Friday morning with a slight niggle in a back tooth. I rang my regular dentist in Sydney and took the first available booking on Monday.
“Mid-afternoon the niggle progressed to a dull ache so I took 2 x 500mg paracetamol tablets. The pain was worse when I arrived home at 6.30pm so I took two more paracetamol tablets, and two more again before bed-time at 10.30pm.
“At 12.30am I awoke with severe toothache. Mine was a pontine stroke, and not wanting to take another gram of paracetamol before time, I rode the pain until 3.30am when I took two Mersyndol Caplets which also contain codeine and doxylamine. This helped me sleep until 7.15am when the pain woke me again.
“Because of the stroke, I have to take blood pressure readings morning and night. Two days earlier, a hospital reading of my blood pressure had been 130/94. Yet this morning the blood pressure reading was 159/112!
“My GP said the elevated blood pressure was most likely due to the severe toothache and resulting lack of sleep.”
After February 1, a situation like this in Dorrigo would require a trip down the mountain to Bellingen Hospital’s emergency department and the summoning of the doctor on duty.
Mr Feros said the Therapeutic Goods Administration (TGA) decision to change codeine-containing medications from OTC to prescription-only, purportedly to reduce problems related to addiction and misuse, “does not make sense”.
“Six per cent of medications containing opioids are obtained from community pharmacies and 94 per cent of them are obtained from doctors’ prescriptions,” he said. “In the US there is a health care crisis due to an epidemic of addictions to prescribed codeine medications.”
Since 2016, about 70 per cent of NSW pharmacies have voluntarily introduced a real-time recording and monitoring system called MedsASSIST to help them identify patients who are at risk of codeine dependence.
Mr Feros says the NSW Government should make MedsASSIST mandatory, rather than regulating that codeine medication only be available with a doctor’s prescription, with no real-time recording of the supply, and no real-time monitoring or counselling available.
“The health problem with opioids is prescription supply,” he said. “Yet this problem will simply be increased by the February 1 regulation.
“Patients can ‘doctor shop’. That is, go from doctor to doctor to get prescriptions for these medications to potentially sell them to the illegal drug market or feed their addiction.”
Mr Feros would like Bellingen Shire Courier-Sun readers to contact NSW Member of Parliament Melinda Pavey’s office on 6562-6190 to register a request that NSW pharmacists continue being allowed to provide patients with acute pain relief medication.
However, when she heard about this, Melinda Pavey responded as follows:
“I thank Mr Feros for his comments regarding the recent changes to the dispensing of the drug codeine. Whilst I empathise with those constituents with chronic pain and/or illness, I must ask anyone concerned about the changes to contact the Australian Government’s Therapeutic Goods Administration (TGA) on 1800 020 653 (Free call) or email@example.com or their local pharmacy. The NSW Government does not regulate the dispensing of therapeutic goods.”
Mr Feros said Ms Pavey was just trying to “duck her responsibilities”.
“The claim that NSW politicians can do nothing about this TGA decision is not correct,” he said.
“Health Minister Brad Hazzard can simply put in place a regulation that provides consumers with convenient access to acute pain relief medication through community pharmacy.
“There is the precedent of Queensland Health, which pioneered the introduction of flu vaccination being available from community pharmacies, although the TGA scheduling was that the flu vaccination only be available on a doctor’s prescription.”
Mr Feros said the NSW Government has the authority to introduce "just when supply” of codeine-containing acute pain-relieving medications, with mandatory recording and monitoring of the three-day supply.
If they don’t, consumers will face increased inconvenience and cost and potentially suffer unnecessary pain.
“NSW politicians cannot hide behind the TGA and allow this to happen,” Mr Feros said.
This story has been updated with additional information from Melinda Pavey MP and Peter Feros.