Codeine prescription changes: How will I manage my pain now?
This week, the Therapeutic Goods Administration (TGA) changed the scheduling of medicines containing codeine – meaning you will now need a prescription from a GP to buy them.
This change is likely to impact thousands of Australians who use codeine to help manage acute or chronic pain associated with common painful conditions including arthritis, nerve pain, fibromyalgia and low back pain.
While there is a role for opioids in the management of pain, it’s important to consider the framework of how it is prescribed including suitability for the patient and their condition, duration and dosage – all of which should be managed by an experienced General Practitioner (GP) or specialist.
The TGA’s change has come as a way of curbing addiction and misuse of the drug.
According to the Australian Bureau of Statistics, opioids were the most common class of drug identified on toxicology reports in drug induced deaths in 2016, making it a serious public health issue, although many of these deaths were caused by opioids other than those available over the counter.
Changing codeine to a prescription only drug means patients living with pain or musculoskeletal injuries will be encouraged to seek alternate pain management treatments such as exercise, physiotherapy and mind/body modalities.
Through the Royal College of General Practitioners (RAGP), GPs have also been encouraged to advise patients presenting with these conditions to seek physiotherapy specialist care in the first instance.
Having suffered from chronic pain for the better part of my 20’s due to a myriad of nervous system and musculoskeletal conditions, I can personally vouch for the fact that long term opioid therapy is not the answer for chronic persistent pain conditions.
After years of unsuccessful medication, hospital interventions and surgeries, ultimately it was a multi-pronged approach that proved the most effective.
I worked off a 10% rule with my pain condition once I realised there was no quick fix when it comes to pain:
- 10% movement / exercise therapies
- 10% sleep hygiene
- 10% manual therapies (physiotherapy and massage)
- 10% pain education – Try Explain Pain by David Butler & Lorimer Mosely
- 10% psychological support (mind set)
- 10% mind/body work with yoga / meditation (balancing autonomic nervous system)
- 10% diet and nutrition strategies
- 10% medical support network
- 10% social support team
- 10% pharmacological treatments (medication)
Although pills can seem like the magic silver bullet, I found it was not until I addressed all of the factors above at the same time, that significant shift occurred in my conditions and pain levels.
The best thing about this approach is that none of the strategies listed above come with the unwelcomed side effects of opioids such as drowsiness/fatigue, dizziness, constipation and mood changes. And they’re not even the severe ones.
By combining these strategies above, you are essentially accessing your brain’s own medical chest which is more powerful than any external chemical you can put in your body. Natural pain killing chemicals are released from your brain when you implement these strategies and optimise your nervous system.
I’m not saying I am perfect, I’m certainly guilty of slipping out of habits. The trick here is to forgive yourself and get back on the wagon, quickly. Work with the 80/20 rule and try to adhere to your plan 80% of the time and let yourself off the hook when and if you do fall off.
Overtime, I came to realise that pain drugs are just a small short-term helping hand in a much bigger picture.