Australia Doctors warned following codeine overhaul

21:21  11 february  2018
21:21  11 february  2018 Source:

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Doctors have been warned to watch out for dependent patients after codeine become prescription-only. Health. Doctors warned following codeine overhaul . Gemma NajemAAP. February 11, 2018 9:03PM.

Doctors have issued a warning about the use of over-the-counter medicines containing codeine following what is believed to be the first published case of acute confusion in a 14-year-old girl.

A file image of medication packets© Provided by AAP A file image of medication packets Doctors have been warned to watch out for codeine-dependent patients following the introduction of prescription-only codeine drugs earlier this month.

Identifying codeine-dependent patients may be difficult, but a study released on Monday says it's vital doctors pick up signs of addiction to prevent serious health complications, which could be fatal.

The study's release comes after products containing codeine, such as Panadeine, Nurofen Plus and Mersyndol, became prescription-only on February 1.

Dr Suzanne Nielsen, lead author of the study published in the Medical Journal of Australia, says doctors need to ask the right questions early, and often, because "it's generally a very hidden problem".

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Researchers found that after the FDA warning , codeine prescribing after a tonsillectomy and/or adenoidectomy decreased by 13.3%. However, 1 in 20 children, or 5.1%, were still prescribed codeine following a tonsillectomy and/or adenoidectomy in December 2015

Codeine is not generally recommended in pregnancy. Tell your doctor before taking codeine if you're trying to get pregnant, are already pregnant or if you are breastfeeding. The warning signs of a serious allergic reaction are

"We don't see any difference between things like age, gender and unemployment," says the senior researcher at the National Drug and Alcohol Research Centre at the University of New South Wales.

"It's definitely more nuanced and some of the stigmatising images for people who commit substance abuse are not helpful for anyone and certainly not helpful for working out anyone with a codeine dependence."

The research, which used data from 41 publications, showed clinical identification of dependence was often delayed and the prevalence of mental health conditions alongside codeine-dependence was very high.

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The AAP has already warned doctors twice over the last 20 years against prescribing the drug to minors, and in Canada and Europe age restrictions are set to children over the age of 12. “We have hundreds of thousands of children still getting codeine

Australian doctors have been warned to watch out for codeine -dependent patients following the introduction of prescription-only codeine drugs earlier this month.

Tolerance to the drug can develop quickly and the harms outweigh the benefits when used in low doses with drugs such as paracetamol and ibuprofen painkillers - which are not made significantly more effective by the addition of codeine, according to the study.

Doctors must build rapport with patients and ask detailed questions about their pain problems, the amount of codeine that's been used and for how long, Dr Nielson said.

"It's not something that might be evident immediately. Often (serious) cases have been identified historically when people have been submitted to hospital with organ damage," Dr Nielson told AAP.

Detoxification and medication based treatments were among a number of options available for those with codeine addictions, but removing the stigma was the first step for people reluctant to come forward and seek help, Dr Nielson said.

"This isn't the fault of the patients, it's the fault of an imperfect medication," the researcher told AAP.

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