The tendency for codeine to cause dependence when used long-term is the reason why codeine will become prescription only from 1 February 2018. Some people who present to their GP to request a codeine-containing analgesic will have an underlying opioid dependence, not always recognised.
The OTC Codeine Assessment Screening Tool can assist in identifying people with a high likelihood of meeting criteria for opioid dependence.
People struggling with dependence on over-the-counter or prescribed opioids generally do not identify as having a ‘drug problem’ and tend not to access traditional AOD treatment services. They come from all walks of life, often are trying to hold down jobs and care for families, and many have a regular GP.
It is anticipated general practice will be the primary source of help for these people. Specialist centres will not have capacity to manage the increased demand alone.
The provision of opioid replacement therapy by GPs will be the beginning of a recovery journey for patients in need.
All GPs can prescribe buprenorphine/naloxone (Suboxone®) for up to five patients without the requirement for formal training or accreditation – because this treatment is safe and effective when carried out according regulations. (S8 Permits and supervised dosing apply)
Supports available for GPs:
QUM practice visit topic De-Mystifying Opioid Replacement Therapy
Pharmacotherapy Networks for contact with GP Mentors (ie GPs who have already taken steps to provide ORT in their practices), prescribing information and practice staff support.
Drug and Alcohol Clinical Advisory Service (DACAS) 24/7 phone support 1800 812 804.
Addiction Medicine Specialists - shared care for complex patients or initiating and stabilising patients’ therapy.