Medicines containing codeine: February 2018 changes

From 1 February 2018, over the counter codeine containing medicines will no longer be available in Australia¹. The Australian Government’s Therapeutic Goods Administration (TGA) has declared that all codeine containing medications will require a prescription from health professionals.

These changes in codeine access will have an impact on many workplace drug and alcohol policies. We have prepared this short article to help you better understand these changes and be appropriately informed.

Many common pain relief and cough, cold and flu medications contain low dose codeine. Up until 1 February 2018, codeine containing medications had been widely used and accessible as an over the counter medicine.

The TGA has placed tighter restrictions on the access to codeine medications due to some consumers exceeding the recommended dose. Evidenced based research suggests excess codeine use can have a detrimental impact on long-term public health, such as liver complications¹. Other common side effects of codeine include:

• Inability to sleep and unusual dreams
• Constipation
• Feeling faint
• Nausea and stomach cramps
• Drowsiness
• Mood changes
• Dizziness

Whilst these changes are relatively new, we can expect to see continued use of codeine medications in the workplace. Many individuals may have legitimately purchased medications containing codeine prior to 1 February 2018. During his transition period, it is important for employers to understand that the use of codeine is not illicit. Therefore, using codeine containing medications purchased before 1 February 2018 is legal.

Workplace drug and alcohol screening in Australia will continue to detect the codeine medications as per AS/NZS 4308:2008. If a positive codeine drug test outcome is recorded, confirmation of prescription from the employee’s treating doctor should be requested. Failure to provide medical evidence of a prescription would suggest the employee is not fit for work.

Reference

1. Roberts, D. M. & Nielsen, S. (2018). Changes for codeine, Australian Prescriber: NPS Medicinewise https://www.nps.org.au/australian-prescriber/articles/changes-for-codeine#references