Prescriptions and the cost of public health

[Pies4shaw]

I see that there were about 10-12 "codeine-related" deaths in Australia per year from codeine over the period from 2000 to 2013. Of those, about 5 or 6 were accidental deaths and about 3 or 4 were suicides.

It appears that the response is likely to be to limit codeine availability to prescription. Is increasing the number of trips to doctors to get drugs that are, by and large, not misused a response that we can or should afford?

[Culprit]

It's unbelieveable that they want to send more people to the Doctors and put even more pressure on the Medicare system over these deaths. Sure they are tragic, but is it out of control seriously, how many over how long? Then again, we have laws limiting everything else so why not.

[stui magpie]

Shouldn't need a script, people can overdose on paracetamol or ibuprofen.

Next they'll want to print warning labels on cherries and peaches.

http://www.bonappetit.com/test-kitchen/ingredients/slideshow/foods-that-can-kill-you/?slide=1

[think positive]

Yeah I take ibrufen and codeine for migraines. Not often, but when I need them they are vital. I don't get a headache first, my vision starts to go blurry, and can get so bad I can't see at all, then I get the mother of all headaches. This only started a couple of years ago. I'm guessing its stress, and I'm trying to minimise my stress levels, but something's are not avoidable. I certainly don't want to be running to the doc when I need them. Maybe time to stockpile!

[Wokko]

The current situation of pharmacists having to question people and decide who is and isn't an addict is pretty crap so I think there are two options, it either goes back to over the counter again and people decide what they want to buy themselves OR we let doctors decide if someone should or shouldn't have the medication.

So while I'm not generally a fan of regulation, in this case it's the less bad option if it's not just freely available.

[partypie]

It will suck if they manage to introduce a GP copayment on top of this.

As Stui pointed out paracetamol and nurophen are not without risks. What if not being able to get a stronger painkiller makes people take dangerous levels of these drugs?

As for medicines causing deaths, how many geriatrics are taking the wrong prescription medications making them sicker and/or making them have falls leading to more hospital admissions?

[David]

It's the old "should we reduce the speed limit to 40 km/h" question: how do you balance mass convenience and efficiency with a handful of deaths? Is there a formula for this?

[Pies4shaw]

The two aren't even comparable. There is no viable analogy.

[David]

Except for the one I just clearly explained?

[Pies4shaw]

Explain again how making people go to the doctor to get a codeine prescription is going to achieve anything beyond an increase in health expenditure (bearing in mind that people already have to be grilled by the chemist to get codeine)?

People inevitably drive slower, on the whole, when the speed limit is reduced because they face a significant risk of penalty. There is no comparable compliance-driver here.

[David]

Presumably the reasoning behind the proposal is that it will reduce the (very small) number of deaths attributable to accidental or deliberate codeine misuse. So, on a basic level, the proposal is to significantly reduce efficiency across the board in order to save a handful of lives.

I'm not disagreeing with you; I just think it's an extremely complicated political/ethical discussion and one that occurs in many spheres, whether it be speed limits or another form of minor regulation.

[Tannin]

That tiny number of deaths is grossly overstated as we have no evidence whatsoever that these damaged people would not have ODed on any of the hundreds of alternatives.

Meanwhile, the hundreds of thousands of sane, responsible, law-abiding Australians who use codeine-based pan relievers will suffer a very great deal. A tiny, tiny dose of codeine in asprin, for example, works very well indeed to deal with tension headaches where asprin alone does not. And when you have a bad tension headache, it's difficult enough to manage getting to the chemist, let alone waiting days for a doctor's appointment by which time the problem is gone anyway.

It is entirely reasonable to predict an increased suicide rate by chronic pain sufferers who are denied a perfectly safe, effective treatment they have been using on an occasional, as-required basis without the slightest trouble for decades, and reasonable also to expect that tyhis stupid move will result in MORE deaths, never mind the greatly increased pain and suffering across the community.

This is beyond stupid. Words fail me to describe the utter insanity of this proposal.

[Tannin]

[Tannin]

[Wokko]

The issue isn't just the deaths, caused largely by the paracetamol and ibuprofen which are dangerous (Codeine is pretty hard to OD on without added opiates/lots of booze), it's the addiction caused by a drug that is a large enough amount in these tabs to start addiction but too small for most pain (for a lot of people Codeine does jack shit).