Updated 18 September 2013

Codeine: watch out!

It’s a white substance, made from opium and relieves pain or induces sleep. And you can buy it across the counter at any pharmacy.

It’s a white substance, made from opium and relieves pain or induces sleep. And you can buy it across the counter at any pharmacy.

But be careful, warns Dr Nicola Rains, a general practitioner at NHC Health Centres.

There is a high risk of dependence, precisely because of its euphoric effect. With chronic use patients may develop tolerance to these effects and require increased doses, which can then cause drowsiness and respiratory depression.

Its pain-relieving effect is enhanced with paracetamol and anti-inflammatories. So it is often found in pain-relieving combination medication and in its pure form as a cough suppressant.

What all of these medications have in common is codeine, which is an opium alkaloid. Because of the possibility of dependence, pharmacies are obliged to control who buys these medications and the quantity purchased.

Keeping track of patients

“The Watertower Pharmacies have controls in place – not only when the patient has a prescription but also when patients buy these medicines across the counter. We ask the patient for personal details and capture this on our database so we can track consumption and prevent possible misuse,” says Heinrich Du Toit, pharmacy operations manager at Watertower Pharmacies.

Du Toit says it is of major concern to health professionals that there is currently no uniform approach to the issue nor a shared database through which patients could be tracked across pharmacies. Because of different pharmacy groups and independent pharmacies, this will not be simple to implement – but it would make it more difficult for patients to consult several practitioners and have a number of scripts filled at different pharmacies without any oversight.

“The SA Pharmacy Council is expected to launch the Codeine Care Project at its upcoming annual conference. The NHC Health Centres and Watertower Pharmacies are fully committed to patient safety and safe dispensing of all medicine including codeine, and we support initiatives that will enable pharmacy networks and independent pharmacies to cooperate on this critical matter,” says du Toit.

(Picture: opium poppy from Shutterstock)


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