Codeine could be banned over the counter
CODEINE sold over the counter could be banned over fears of an opioid addiction crisis, a watchdog has warned.
The Medicines and Healthcare products Regulatory Agency (MHRA) yesterday said it is considering reclassifying common painkillers such as co-codamol, co-codaprin and Nurofen Plus to make them prescription only.
Such a move would form part of a mounting crackdown on the inappropriate use of painkillers following a report last year indicated that Britain is sliding towards a Us-style opioid crisis.
A highly addictive opiate, codeine in its more potent form currently requires a prescription. However, when combined with other painkilling drugs, such as paracetamol or ibuprofen, or in liquid form as a cough remedy, it is available over the counter.
Although opioids are not intended for chronic pain and are supposed to be used for a maximum of three days, there is growing concern that millions of Britons have become addicted to them as a long-term solution.
In September 2019, Public Health England (PHE) reported one in four adults in the UK was being prescribed potentially addictive drugs, with half of them still hooked a year later.
The first official mapping of dependence on heavy painkillers – described by Matt Hancock, the Health Secretary, as “disturbing” – found 5.6million people were on opioid pain medications.
Last night, a spokesman said: “The MHRA is keeping the safety of overthe-counter products containing codeine under review and will consider other interventions, including reclas- sifying all opioid-based painkillers as prescription only, as necessary.”
The news comes two days after the National Institute of Health and Care Excellence (Nice) issued new guidance warning doctors not to prescribe paracetamol, ibuprofen and opioid drugs for long-term pain.
The agency, responsible for setting clinical standards in the NHS, said there was “little or no evidence” that the medicines improved quality of life. Although its guideline did not explicitly mention over-the-counter medication, Nice later confirmed opioids should not be offered to anyone aged over 16 to manage long-term pain. However, GPS’ leaders have suggested that recommended alternatives to painkillers, such as acupuncture and exercise, are not readily available.
More than 20million people in the UK are thought to be suffering from chronic pain, defined as lasting or recurring for more than three months.
Codeine comes in tablet form, as a liquid to swallow, or as an injection. Codeine injections are usually only given in hospital.
The drug is available over the counter in lower strengths when combined with paracetamol, in the form of cocodamol, or aspirin, in the form of cocodaprin, or ibuprofen, which is sold as Nurofen Plus.
The MHRA said these should be purchased “under supervision of a pharmacist”. The 2019 PHE report found that in England, almost 12 million adults a year are being prescribed drugs on which they may become dependent.
Up to a third of patients had been on them for at least three years, including 930,000 people on antidepressants, 540,000 on opioids and 160,000 on gabapentinoids.
Often, patients were taking more than one type of treatment, with more than half a million people on a cocktail of opioids and antidepressants.
Mr Hancock said at the time: “I refuse to let this escalate to the level seen in the United States. This review is a wake-up call.”