In an effort to target theft and misuse of prescription cough medicine containing codeine, the province of British Columbia is changing the scheduling of the drug.
Starting on January 2, 2020, cough medicine containing high amounts of codeine will need a special prescription and will be stored in a time-delay safe at the pharmacy.
David Pavan, deputy registrar at the B.C. College of Pharmacists, tells Yahoo Canada that the changes won’t have any significant impact on patients in the province.
“They will just carry a different piece of paper to their pharmacy,” he says.
The new regulations come after regulators noticed an increase in forged prescriptions for products that contain liquid codeine, an opiate pain killer used to treat mild to moderate pain. Software was being used to make fake prescriptions in order to obtain the medicines, which have seen a spike in recreational abuse, particularly amongst a younger demographic. According to the 2018 Canadian Community Health Survey, the most commonly used opioid pain medications were products that contained codeine. The survey found that 3.7 million Canadians aged 15 and older admitted to having used an opioid pain medication.
Along with the fake prescriptions for these products, there has also been a number of targeted robberies, in which these products were brazenly being stolen from behind the counter.
In order to address these two issues, the B.C. College of Pharmacists proposed that the drug schedule of these products change, from Schedule 1 to Schedule 1a.
Products that fall in the later category have two strict requirements: The first is that they must be written on a duplicate physician-specific prescription pad, where one copy of the script goes to the pharmacy and the other stays with the physician. Since these prescriptions pads are unique to each physician, it makes them hard to forge.
The second requirement is that the products be kept in a time-lock safe, in order to discourage theft.
“Being kept in a time-lock safe will prevent the grab-and-run robberies we were experiencing,” says Pavan. “Now if you request these products, the pharmacist has to enter a code into a safe and it takes five minutes to open.”
There are some products of low concentration codeine in liquid form, which are considered Schedule 2 drugs. These don’t need a prescription but are kept behind the counter.
Pavan says he’s talked to other provincial regulators, who’ve experienced similar issues around theft and forgery.
“They’re interested in the steps we’ve taken and...I wouldn’t be surprised if other jurisdictions adopted this,” he says. “The impact to the patient is very minimal if at all, yet the reciprocal public safety is significant.”
CODEINE CONTAINING LIQUID PREPARATIONS INCLUDED IN SCHEDULE CHANGE:
ACETAMINOPHEN ELIXIR WITH 8MG CODEINE PHOSPHATE SYRUP
PMS-ACETAMINOPHEN WITH CODEINE ELIXIR
DIMETANE EXPECTORANT C