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Changes to codeine-based pain relief

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Changes to codeine-based pain relief by 1 Feb 2018

From 1 February 2018, all products that contain codeine will no longer be available over the counter from pharmacies.

This change includes all pain relief (analgesics) like Panadeine, Nurofen Plus and Mersyndol, as well as all cough, cold and flu products which contain codeine, like Codral, Demazin and any pharmacy generic products which contain codeine.

So what does this mean for us as people living with HIV (PLHIV)?

Many PLHIV experience painful peripheral neuropathy or chronic pain associated with other health conditions and rely on pain relief that contains codeine. You’ll need to have a prescription to obtain this kind of medication from 1 February 2018. This policy change means you’ll need to plan to get a prescription from your doctor to ensure you have the pain relief you need on hand before you need it.

Talk to your doctor about accessing codeine-based analgesics on prescription or discuss what other alternative options might be helpful for you. Depending on your type of pain, discuss with your doctor options of writing repeats to make the most of your appointment time. If you have repeat scripts, you can ask your pharmacist to send you reminders when you’re low on these repeats. Some GPs also have alternative options to request your scripts online.

Your pharmacist is also a useful source of information and advice to find alternative over-the-counter preparations. Let them know if you’re taking anti-retrovirals (ARVs) so they can also advise on any drug interactions. Paracetamol/ibuprofen combinations are usually offered as an alternative to the codeine-based analgesics. Ibuprofen products should be used with caution and under the guidance of your doctor, as many PLHIV have increased risk of renal, liver or kidney damage.

Sometimes non-drug approaches to manage symptoms, treatment side-effects or reduce chronic pain can likewise be useful. Ask your GP to write you a Chronic Disease Management (CDM) Plan or a Team Care Arrangement (TCA). This plan can increase your eligibility for Medicare benefits towards the cost of services such as physiotherapists or other allied health professionals who can support you with pain management solutions.

For many of us, regularly assessing how we manage pain can make a big difference to how much pain affects our daily life and quality of life. Some of these practices include exercise, massage, acupuncture, therapy, hydrotherapy and yoga. Your doctor can help with referrals to a pain specialist or pain management clinic. Another solution can be changes in your diet, in consultation with a dietician, such as removing or reducing wheat, dairy, refined sugar, red meat or other foods that may be causing inflammation. Keeping well hydrated, 1.5 to 2 litres of fluid a day, is also important.

Most clinicians take pain seriously, so please feel confident when instigating this conversation. Do make sure you book a long appointment which will give you time to discuss your pain management plan. It may be useful if you keep a record of the intensity, location, triggers, and patterns of your pain. Another option is to use a pain tracker app (in iPhone or Android) to keep track of your pain and create a detailed record of your experience of pain so you and your doctor can better understand what’s going on. These tools can be valuable to have on hand when discussing this issue with your doctors.

The Pain Management Network website has a number of resources that can be useful to build your skills and knowledge about managing your pain in partnership with your healthcare team. There are Chronic Pain Services in NSW, metropolitan and regional, which can offer access to a multidisciplinary team of healthcare professionals for assessment and diagnostic services. These services look at the impact of pain on your activity levels and quality of life and develop a plan in partnership with you and your GP.

If you think you would like to explore your options with a Chronic Pain Service, flag this as soon as possible with your GP. There is high demand for these services so waiting times for an initial appointment can range from weeks to months.

If you’re having difficulties with this change and want to talk through your strategies and options, please call one of our Treatment Officers on (02) 9206-2177 or 1800 245 677 (freecall).

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