Restrictions on painkillers containing codeine

Restrictions urged on painkillers

Wednesday, 21 January 2009
http://newsvote.bbc.co.uk/1/hi/health/7840333.stm


Painkillers containing codeine should be sold in smaller packets and available only after consultation, a parliamentary report has recommended.

The cross-party inquiry into painkiller dependency said drugs such as Nurofen Plus and Solpadeine Plus should come with a warning about addiction risks.

Any advertising of this class of painkiller should stop, it recommended.

The report also urged better monitoring of patients on prescription painkillers and anti-depressants - and their GPs.

The Department of Health needed to set up procedures to ensure that GPs were not prescribing opiates and tranquilisers without good cause, the All Party Parliamentary Drug Misuse Group concluded after a year-long inquiry.

Pharmacists should be encouraged to report GPs who appeared to be prescribing outside of guidelines to the local Primary Care Trust.

Fewer tablets

The group conceded there was a lack of information about the scale of addiction to either prescription-only or over-the-counter drugs, and said the Department of Health should start collecting these figures.

A further pack size reduction to 18 tablets would cause inconvenience and have no effect on addiction

Sheila Kelly
PAGB

But it did say it had heard from individuals who had taken anti-anxiety medication for 30 years, despite guidance that it should not be prescribed for longer than four weeks at a time.

Concerns have been raised in recent years about the number of people regularly taking drugs containing codeine, an effective analgesic which is combined with other painkillers such as paracetamol, ibruprofen or aspirin for over-the-counter sale.

Withdrawal after prolonged-use can result in flu-like symptoms, with joint pain and restlessness. In many countries, including the US, it is banned in non-prescription drugs.

Dr Brian Iddon, the MP who chaired the group said he was "shocked by evidence that a considerable number of people in the UK are addicted to over-the-counter products containing codeine.

"The issue cannot be ignored any longer. We must establish the scale of the problem and provide proper diagnosis and treatment for those affected."

The inquiry wanted to see a reduction in the size of packets - which can currently contain up to 32 tablets - to 18 and said that they should only be available after consultation with the pharmacist about the problem.

The Proprietary Association of Great Britain, which represents manufacturers of over-the-counter medicines, stressed drugs containing codeine were very effective in treating pain, and that much of the information available on addiction was anecdotal.

Misuse of medicines is difficult to control, especially when customers can go from pharmacy to pharmacy to make purchases

Royal Pharmaceutical Society of Great Britain

"The PAGB is happy to discuss whether the warnings can be improved, but believes a further pack size reduction to 18 tablets would cause inconvenience and have no effect on addiction," said chief executive Sheila Kelly.

There is no legal restriction in any event on the number of packets a single person can buy, the PAGB added, and noted that they already carried warnings about the risk of addiction.

David Pruce, director of policy at the Royal Pharmaceutical Society of Great Britain, said pharmacists were working hard to spot the abuse of painkillers.

"However, misuse of medicines is difficult to control, especially when customers can go from pharmacy to pharmacy to make purchases," he said.

"Systems to share information on local patterns of misuse should be developed, involving all health professionals to help the situation."

The charity DrugScope, which helped with the inquiry, said it hoped "the report will be the catalyst for much greater awareness of the potential harms that prescription and over-the-counter drugs can cause".

Other recommendations in the report included making all information from clinical trials available - including those which are abandoned - amid concerns that drug companies only publish favourable data.