Inconsistent Codeine
Moves are afoot in National’s “War on Drugs” to restrict the sale of codeine in all its forms, including the combinations with paracetamol (Panadeine, Codalgin et al.). The Herald reports:
“Public access to a widely-used class of painkillers containing codeine is likely to be restricted within months because of what is said to be an increase in the rate of addiction to the opium-linked drug.
“The recommendations of a Government advisory committee on the painkillers mirror the controls on pseudoephedrine, an ingredient in many cough and cold medicines, and also a precursor of the illegal drug P.”
This is not strictly accurate reporting. Although no legislation has been passed, the proposed legislation for pseudoephedrine is far tougher than the legislation proposed for codeine. Pseudoephedrine is supposedly only going to be available on a controlled drug script. No clicking on a couple of buttons and printing a script. The GP has to go to the safe in which the controlled drug scripts (which are numbered) are kept. He has to write the script out in long-hand (remember doctor’s handwriting, anyone?) and give three copies to the patient. He can prescribe no more than a months supply. Contrast this to codeine which is merely to be kept in the pharmacy area and dispensed by a pharmacist without a prescription (as long as it is in combination with another product).
Now some comparison facts.
Pseudoephedrine can be made into a noxious drug called Methamphetamine (“P”, “Meth”). It is difficult to extract from a combination product and requires a full laboratory. By-products of its conversion to methamphetamine are noxious and explosive.
Codeine can be made into the most addictive, dangerous drug known to man, Heroin (“Smack”, “Diamorphine”). It is dead easy to separate from combination products. It requires little in the way of laboratory equipment and is quite easy and safe to make.
Would someone care to explain to me why it is acceptable to have codeine (a fairly useless painkiller) easily available and yet have pseudoephedrine (the only useful decongestant) nearly as inaccessible as the moon?
Of course, that is no less consistent than having alcohol and tobacco freely available from every store when they are both equally as dangerous as methamphetamine as this graph from the Lancet shown below demonstrates:
Note: This is physical harm to the user NOT cost to society.
Heroin comfortably sits just about off this chart.
But we are restricting access to flu tablets. Is it any wonder that we are losing the “War on Drugs”?
Related posts:
- Cheap Drugs I’m probably a little slow on the uptake, but it...
- Banning “P” No, not methamphetamine. That’s already banned. John Key is proposing...
- No Relief So John Key is going to make pseudoephedrine only available...
- Pseudo-intelligent Take a good look at the above image. It tells...
- Pseudo-intelligent Part 2 I see Sir Peter Gluckman seems to have found his...
Jan 21 10 12:50 am
One of the criticisms of availability of codeine is the effect of dependency. Panadeine (equiv.) is my preferred painkiller and I don’t believe I have dependency – do you think it should be regulated? I personally don’t wish to have access to my preferred painkillers reduced because of some issues with a small piece of the population.
Jan 21 10 7:49 am
Mark: do you think it should be regulated?
Not at all. The proposed restrictions for codeine-containing products seem reasonable and allow you to access them with little problem. My question is: why the severe restriction on pseudoephedrine?
Jan 21 10 1:28 pm
MacD, it is being restricted so severely because it makes an enormous amount of money for its suppliers. govt’s hate such competition and will do anything possible to either take over the business (which is socially unacceptable at this point in time) or do their utmost to outlaw it.
Thieves and liars in suits and with self appointed honorifics are still thieves and liars.
Jan 21 10 3:47 pm
I disagree Pique, the reason to me is that it’s part of a “seen to be doing something” syndrome that governments suffer from very badly. Even reasonable restrictions on Pseudoephedrines would stop quantities of value to P manufacturers being available in any volume. The huge majority of P precursors are apparently imported (illegally) with Customs intercepting about 1%. Unless they can cut that flow, restricting domestic sales seems pointless.
Jan 22 10 1:26 am
pollies default position on anything is to tax it.
I agree that in this case they are “being seen to do something” but that is because they haven’t worked out how to tax it yet in a socially acceptable manner, and they won’t risk the public pulling their snouts out of the trough.
Jan 23 10 2:26 pm
I would be interested to examine the data used to create the Lancet graph. Some aspects appear to be spurious – how much physical harm does heroin cause if unadulterated and available in sterile form and in predictible doses? Occasional pulmonary oedema, perhaps. If memory serves me correctly heroin was used medically in the UK fairly widely in the early part of the last century, with few problems. Is it really more addictive than nicotine? I doubt it. We know that at least 20% of people who ever use nicotine are long term (and the majority of these lifelong) addicts. That is not the case for heroin.
I am no advocate for reducing restrictions on drug availability, but unfair arguemnts are not convincing.
Jan 23 10 2:45 pm
Amelie:
Heroin is substantially more addictive than Tobacco and it’s withdrawal effects are severe enough to be dangerous. Bear in mind that the Lancet graph is created from epidemiological data that is mostly hospital and public health data. The potential harm being measured is the harm experienced in unsupervised recreational use. Methylphenidate (Ritalin), for example, is used widely for ADHD but causes little or no physical harm or dependence in the clinical situation. It is a different story as a drug of abuse where it causes as much physical damage as alcohol and tobacco. This is because the effect of Ritalin plateaus quickly and you need more of the drug to attain the same high. This is true for most of the drugs to the right of alcohol on the Lancet graph.
Tobacco and Alcohol, on the other hand, tend not to plateau and do not produce the same “hit” at higher doses – only more side effects and more withdrawal effects. People stabilise at a level of consumption of tobacco, or alcohol, and stay at that level for years. This does not happen with, say, heroin in the abuse state (it may have happened in the clinical context – I have never used the drug clinically – or socially
).
Jan 23 10 6:29 pm
What is your interpretation of the data from Sydney relating to the dramatic decline in overdoses and heroin fatalities following the introduction of injecting rooms? Do yu think the physical harms (in you graph) would be ameliorated if facilities like this were available elsewere?
Certainly. Once you introduce safer alternatives to addicts, they are usually quite willing to go along with it. But this is a far cry from simply legalising a drug.