Prescription opioids – understanding recent changes to Australian regulations
- a lack of evidence of increased benefit for pain or cough relief over similar medicines not containing codeine
- marked variability in its transformation to morphine in individuals, with the potential for severe toxicity in very rapid metabolisers
- widespread inappropriate use to treat chronic pain
- increasingly common extra-medical use in Australia and internationally
- misuse of OTC codeine products resulting in deaths from hepatic injury, gastrointestinal perforations and respiratory depression.
The TGA’s rescheduling of codeine is part of a long-term trend of restricting the availability of opioids, which were once incorporated in a vast array of medicines and used with little or no supervision. Nevertheless, many other opioid drugs continue to be used legally and illegally worldwide. In this article, we take a look at the major opioid drugs and how they are used and regulated in Australia.
What are opioids?
- opiates – drugs naturally derived from the opium poppy, such as codeine and heroin
- semi-synthetic opiates – such as hydromorphone and oxycodone
- synthetic opioids – such as fentanyl and methadone.
A brief history of opioid drugs
- elimination of the risks of blood-borne virus transmission associated with injecting
- reduction in the risk of opioid overdose through a quality controlled and precise dose
- replacement of heroin, with a street value of $220 per gram in 2016 (about four times the price of gold).