It took Australia longer than the United States and the United Kingdom to realize that codeine, a habit-forming popular opiate, is often abused because of its sedative effects. However, beginning February 2018, the country imposed the much-needed restrictions on codeine medications by changing its status from over-the-counter (OTC) to prescription drugs. The new law thus banned the sale of painkillers such as Panadeine, Mersyndol, Nurofen Plus, generic pain relief drugs and some cold and flu medicines as OTC.
With the restriction coming into effect from Feb. 1, 2018, Australia joined the league of 26 nations that have banned over-the-counter sale of codeine-based painkillers. Subsequently, many Australian pharmacy retailers have emptied the shelves filled with codeine medications, while drug manufacturers have rolled out new medicines by mixing ibuprofen with paracetamol. The ruling has led GlaxoSmithKline Australia to withdraw its codeine-containing analgesics Panadeine, Panafen Plus, Panadeine Rapid Soluble and Panadeine Extra from the market.
According to Health Minister Greg Hunt, the decision to restrict the sale of codeine-based painkillers has been taken in response to the growing global opioid crisis that has claimed millions of lives so far.
Supporting the move, health experts say that prolonged codeine misuse has put the health and lives of many Australians at risk. As per Dr. Tony Bartone, vice president of the Australian Medical Association, codeine was being misused for too long, as people used it inappropriately “putting themselves at risk, putting their organs at risk and putting their own health at a long-term damage.” The decision was all about reducing the level of codeine in the community, he said.
Difficult phase of transition
With the curbs on codeine sale, patient advocates have suggested chronic pain sufferers to avoid self-medication and instead see their doctors or GPs for advice on transitioning. They have asked the government to institute a nationwide action plan to give people access to alternative treatment options to manage their pain. Reports from the Pharmacy Guild of Australia confirm that many people have managed to stockpile ahead of the ban.
Though the new law aims at reducing the risks associated with long-term use of codeine, there is a growing concern that its unavailability might lead to an increase in cases involving withdrawal symptoms. Going cold turkey on codeine carries the risk of severe withdrawal symptoms, including irritability, hallucinations, psychosis and drug cravings. Individuals dependent on codeine should opt for treatment for addiction through a medically supervised program. There is already a surge in the number of people signing up for codeine addiction treatment programs.
Harms of codeine abuse
Codeine is an opiate used in suppressing cough and mild to moderate pains by binding to opioid receptors that are responsible for communicating pain sensations throughout the body. Given the drug’s calming effects, it is addictive. The drug’s abuse can lead to physical and psychological dependence. When abused in higher quantities, it may lead to respiratory collapse, cardiac arrest, loss of consciousness, or may even prove fatal. Treatment for codeine addiction involves a combination of medication-assisted detoxification program, therapies or counseling sessions.
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