Imagine a medicine cabinet staple suddenly becoming a prescription-only item. This is the reality for codeine linctus, a widely used remedy for dry coughs. Recent data from the Office for National Statistics revealed a troubling increase in deaths involving codeine. This alarming trend has prompted regulatory bodies to take decisive action.
The reclassification of codeine linctus to prescription-only status is a significant shift aimed at curbing misuse and ensuring patient safety. As healthcare professionals, it is crucial to understand the reasons behind this change and how it impacts both your practice and your patients.
Read this blog to explore the implications of this reclassification and the steps you need to take to adapt to this new regulatory landscape.
Key Takeaways
What is Codeine Linctus?
Codeine linctus is an oral solution containing codeine, an opioid used primarily to treat dry coughs. It works by suppressing the cough reflex in the brain, providing relief from persistent coughing.
Previous Classification
Until recently, codeine linctus was available over the counter (OTC) in pharmacies. However, due to increasing concerns about its misuse and potential for addiction, it has now been reclassified as a prescription-only medicine (POM).
Reasons for Reclassification
Risks of Dependence and Addiction
Codeine, like other opioids, carries a significant risk of dependence and addiction. Regular use, even as prescribed, can lead to physical and psychological dependence. The reclassification aims to mitigate these risks by ensuring that codeine linctus is used under medical supervision.
Overdose Risks
For individuals who are ultra-rapid metabolisers of codeine, the risk of opioid toxicity is heightened. Symptoms of opioid toxicity can resemble those of an overdose, including respiratory depression, pinpoint pupils, coma, and even death. By making codeine linctus prescription-only, healthcare providers can better monitor and manage these risks.
Recreational Abuse
Codeine linctus has been misused in recreational drinks such as "Purple Drank," leading to increased risks of sedation and overdose. The reclassification is a step towards curbing this dangerous trend and protecting public health.
Approved Use and Effectiveness
Approved Use
Codeine linctus is approved solely for the treatment of dry cough. It is particularly effective in managing chronic coughs that persist for more than eight weeks.
Effectiveness
Studies have shown that codeine linctus is effective in reducing the frequency and severity of chronic coughs. However, using it under medical supervision is essential to avoid potential side effects and misuse.
Professional Responsibilities
Patient Guidance
Healthcare professionals should advise patients with long-term coughs to consult a healthcare provider for a thorough review. This may include additional medical assessments to identify any underlying causes of the cough.
Review of Product Characteristics
It is crucial for healthcare providers to review the Summary of Product Characteristics (SPC) for codeine linctus. This document contains vital warnings and contraindications, especially for patients with a history of substance abuse.
Record Keeping
Ensure that prescription details for codeine linctus are recorded in the patient’s summary care record or equivalent. Encourage patients to read the accompanying Patient Information Leaflet (PIL) to understand the correct usage and potential risks.
Monitoring and Reporting
Monitoring Side Effects
The Medicines and Healthcare products Regulatory Agency (MHRA) has been monitoring the risk of addiction to codeine for several years. Despite regulatory actions to improve product information and labelling, the risk of dependence and addiction remains significant.
Adverse Reactions Reporting
Healthcare professionals should report any suspected adverse reactions to the Yellow Card scheme. This helps regulatory bodies monitor the safety of medicines and take appropriate action when necessary.
Data and Statistics
National Poison Information Service Data
Between January 2017 and May 2022, the National Poison Information Service received 19 calls related to codeine linctus, including its misuse in recreational drinks. This data underscores the need for stricter control measures.
Office for National Statistics Data
Data from the Office for National Statistics revealed an increase in the annual number of deaths involving codeine, from 88 in 2011 to 200 in 2021. This statistic highlights the growing public health concern and the necessity for reclassification.
Conclusion
The reclassification of codeine linctus to prescription-only status is a crucial step in addressing the risks of dependence, addiction, and overdose. It ensures that the medicine is used appropriately and under medical supervision, thereby enhancing patient safety.
Healthcare professionals must stay informed about this reclassification and its implications. They must ensure that they provide accurate guidance to patients, review the SPC, maintain thorough records, and report any adverse reactions. By doing so, they contribute to a safer healthcare environment and better patient outcomes.
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FAQs
What does codeine linctus do for a cough?
Codeine linctus helps suppress the cough reflex in the brain, relieving dry, persistent coughs. It is particularly effective for chronic coughs lasting more than eight weeks.
Is codeine linctus banned in the UK?
Is codeine linctus still available?
Is codeine linctus an opioid?
What is the care codeine oral solution?
What is codeine solution?
What is codeine 25mg/5ml oral solution?
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