Pharmacist urges users to give codeine alternatives ‘red hot go’

PEOPLE who say nothing but codeine effectively relieves their pain had not given the alternatives a “red hot go,” Sandra Fitzgerald, clinical editor of Hunter New England Health Pathways, says.
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Ms Fitzgerald, who also works as a community pharmacist, said she was looking forward to codeine becoming a prescription-only medicine on Thursday.

Related reading: Codeine ineffective and unpredictable She said she would be “relieved” to not have confronting conversations with people who were not used to taking “no” for an answer.

“They really do bully you sometimes,” she said.

She did not believe community pharmacy was an appropriate place to be counselling patients about codeine, particularly for chronic pain, because it was so multifactorial.

“There are so many layers to it, and the assessment process is quite a long one,” she said.“While a lot of us may have the skills and training to do that, we certainly don’t have the time or the space or privacy that’s needed to have those conversations.”

Ms Fitzgerald was part of a “Nationally Coordinated Codeine Implementation Working Group,” formed to educate the community of the changes to the availability of low-dose codeine-containing medicines.

She said there was no good evidence for using codeine for chronic pain, and no good reason to use it for acute pain either.

“Alternatives like paracetamol and ibuprofen are just as good, if not better,” she said.

“If a patient feels that it is not enough for an acute pain episode, then they really need to have an investigation done by a health professional to find out what the cause of their pain is, because maybe it isn’t something you can fix with an analgesic that needs a closer examination.”

Ms Fitzgerald said it was not a hopeless situation, but a hopeful one.

“Rather than being dependent on medication and living half a life, live a full life by going down this other road which is more effective and more sustainable,” she said.

“I really encourage people to seek help from their GP or a specialist pain service, because the other things do work if you give them a red hot go.”

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