As the Therapeutic Goods Administration (TGA) considers the scheduling of pain-killing medication, codeine, Professor Stephan Schug, Director of Pain Medicine at Royal Perth Hospital and Chair of Anaesthesiology, University of Western Australia, has urged the regulator to make the medication prescription-only.

Prof Schug argues codeine is a poor pain management therapy when used on its own, doing more harm than good in many cases.

“Codeine is a poor pain killer; it’s unpredictable and there are risks associated even with its appropriate use. There are many people in the population who carry a gene, which makes codeine quite dangerous,” Prof Shug said.

He further advised there is little evidence to support the effectiveness of low-dose codeine in combination with other pain killing medications, including ibuprofen or paracetamol.

Speaking to The West Australian on June 29, 2016, Prof Schug said many of his patients, who are not experiencing pain relief from the low dose medications, are actually increasing their daily volume of the medication, which is dangerous and potentially life threatening.

“When you buy it over the counter, at 12mg of codeine per 500mg of paracetamol, it is ineffective for pain relief.

“But if you buy a lot to get the morphine effect of the codeine — 60 to 80 tablets, like some of my patients admitted they take a day — you also destroy your liver with the paracetamol, or your kidney and stomach lining with the ibuprofen,” said Prof Shug.

By making codeine a prescription only medicine, Prof Shug maintains Australia would not only be better looking after those at-risk of developing a dependency to the medication, but it would also bring us in line with most other Developed nations.

Echoing Prof Schug’s calls, Kim Ledger, father of the late, Heath Ledger, has urged Australians to be aware that those who use medications such as codeine, could be living with an opioid dependency, and potentially at-risk of death.

“Don’t leave people alone when they are in this situation. You need to still love them. It doesn’t matter. People still need to be loved, regardless of what their personal situations are. And certainly, the people who are using and suffering the consequences of addiction,” Mr Ledger said.

Read Prof Schug’s full argument against making codeine an over-the-counter (OTC) medication here.