FACULTY FOCUS campusreview. com. au
The codeine strain
Prescriptions won’ t address all the reasons for recent increases in opioid deaths.
Amanda Roxburgh interviewed by James Wells
Requiring prescriptions for codeine, in a vacuum, is highly unlikely to curb a spike in overdoses, University of New South Wales researchers say.
This comes after the Therapeutic Goods Administration recommended codeine and all drugs containing codeine, including Panadeine and Nurofen Plus, be made available only via prescription.
Research from UNSW’ s National Drug and Alcohol Research Centre( NDARC) shows codeine-related deaths more than doubled between 2000 and 2009.
The study“ Trends and characteristics of accidental and intentional codeine overdose deaths in Australia”, published in the Medical Journal of Australia, indicates that during those years, codeine-related deaths rose from 3.5 people per million population to 8.7 people per million. Of the 1437 overdose deaths examined in the research, 48.8 per cent were accidental and 34.4 per cent were intentional. The remainder were of undetermined intent. But due to the complex factors behind overdoses, the lead researcher in the study, NDARC senior research officer Amanda Roxburgh, says making codeine prescription only, in isolation, is not going to solve the issue.
“ We don’ t think there is one strategy that is going to address these harms. We think it [ requires ] much more of a holistic strategy in involving doctors in patient education,” Roxburgh says.“[ That means ] talking about more holistic care for issues of mental health and the chronic pain problems and trying to provide comprehensive care around those issues.”
Here, Roxburgh details her research into codeine-related mortality rates in Australia and explains the findings.
CR: Amanda, could you begin by giving us an outline of the key points of your research? AR: [ Overdoses ] have increased due to codeine. What is driving the increase is people inadvertently overdosing on the drug. I guess the more worrying trend was that in the majority of these deaths [ people were using ] other drugs at the same time.
What were these other drugs? Predominantly things like benzodiazepines – Valium, Xanax, drugs like that. Also some of the other stronger opioids, such as Oxycodone and morphine, [ figured ] in some of the deaths.
Clearly, taking these drugs in combination is going to increase the risk of overdose.
26