Information about changes to codeine & opioids


Resources to help support GPs and their patients

Pain management is a core general practitioner skill. But the complex (and sometimes controversial) nature of pain, particularly the management of chronic pain, can push the limits of this skill. Drug therapies will only ever have a partial role in managing complex biopsychosocial issues that characterise pain management. In the modern health environment, we must explore and use non-drug therapies, and redefine the place for existing medications.

The upscheduling of codeine to prescription only in 2018 has provided the opportunity for GPs to:

  • talk to their patients about managing their pain more effectively and safely;
  • provide help and support for patients with addiction issues;
  • develop an appropriate management plan that can be reviewed on a regular basis.

In June 2020, changes were made to reduce the pack sizes of opioid medications that can be prescribed, for both first and second line listings, in short and long-term pain settings. This is to help reduce harms and side effects that may result from opioid medication, while still ensuring access for those who require opioids as part of their pain management.

We have compiled a list of available resources to help support you, your practice, and your patients with these changes.


Prescribing drugs of dependence: RACGP
Reducing opioid prescribing in general practice – 12 point challenge to GPs: RACGP
Drugs of dependence: responding to requests: RACGP

2020 amendments

Revised opioids PBS listings from 1 October 2020: Pharmaceutical Benefits Scheme
Summary of PBS opioid listings for the treatment of pain as of 1 June 2020: Pharmaceutical Benefits Scheme
Prescription opioids: what changes are being made and why: Therapeutic Goods Administration
Prescription opioids: information for health professionals: Therapeutic Goods Administration
Opioid resources: Therapeutic Goods Administration

2018 upscheduling changes

Over-the-counter codeine: changes to supply – Information and resources for health professionals: NPS Medicinewise
Current list of up-scheduled codeine containing products: Therapeutic Goods Administration
Codeine information hub: Therapeutic Goods Administration
Tips for talking about codeine: guidance for health professionals with prescribing authority: Therapeutic Goods Administration
Codeine prescriber toolkit: Scriptwise
Managing patients with regular OTC codeine use: Drug and Alcohol Services South Australia
Codeine Becomes Prescription Medication Western Australia Primary Care Quality Use of Medicines Working Group

State Resources

Codeine rescheduling: Department of Health and Human Services Tasmania
Medicines containing codeine: Queensland Health

HANDI interventions- some non-drug alternatives

Advice to stay active for people with acute low back pain
Exercise for acute lower back pain
Exercise for chronic low back pain
Splints for the reduction of pain from hand osteoarthritis
Mindfulness and CBT for chronic low back pain


2020 amendments

Prescription opioids: information for consumers, patients and carers: Therapeutic Goods Administration

2018 upscheduling changes

Medicines with codeine – what you need to know: NPS Medicinewise
Over-the-counter codeine: changes to supply: NPS Medicinewise
Patient resources available in English, easy English (with pictures), Arabic, Simplified Chinese, Traditional Chinese, French, Greek, Hindi, Italian, Korean and Spanish.

General information for patients

Opioids: Healthdirect
Codeine: Healthdirect
Pain and pain management – adults: Better Health Channel
Codeine information hub: Codeine use can be harmful: Therapeutic Goods Administration
Codeine information hub: How and where to get advice: Therapeutic Goods Administration
Codeine information hub: chronic pain management video resource: Therapeutic Goods Administration
Community toolkit (for patients): Scriptwise
Information for consumers having difficulty ceasing their over the counter codeine medications: Drug and Alcohol Services South Australia
Pharmaceuticals: Alcohol and Drug Foundation
Help and support: Alcohol and Drug Foundation

All state and territory health authorities have 24–hour telephone access to assist drug and alcohol queries.
 

State/terrritory

Legislative framework

24-hour clinical advisory services

Australian Capital Territory

Pharmaceutical Services Section,
ACT Health – 02 6205 0998

Drug and Alcohol Clinical Advisory Service – 02 5124 9977

New South Wales

Pharmaceutical Services Unit,
NSW Health – 02 9391 9944

Drug and Alcohol Specialist Advisory Service – (02) 8382 1006 (Sydney)
1800 023 687 (rural)

Northern Territory

Poisons Control Unit,
Department of Health – 08 8922 7341

Drug and Alcohol Clinical Advisory Service – 1800 111 092

Queensland

Healthcare Approval and Regulation Unit,
Queensland Health – (07) 3708 5264

Alcohol and Drug Information Service – 1800 177 833 (to be put through to Alcohol, Tobacco and Other Drugs for clinical advice)

South Australia

Drugs of Dependence Unit,
SA Health – 1300 652 584

Drug and Alcohol Clinical Advisory Service – 08 7087 1742

Tasmania

Pharmaceutical Services Branch,
Department of Health and Human Services – 03 6166 0400

Drug and Alcohol Clinical Advisory Service – 1800 630 093

Victoria

Drugs and Poisons Regulation,
Department of Human Services – 1300 364 545

Drug and Alcohol Clinical Advisory Service – 1800 812 804

Western Australia

Pharmaceutical Services Branch,
Department of Health – 08 9222 6883

Clinical Advisory Service – 08 9442 5042