Cough syrups with codeine to become controlled medications

According to new regulations by Health Canada, codeine-containing cough syrups will soon require a special type of prescription and will also be locked in vaults at pharmacies. Currently, most Canadian pharmacies also sell codeine in eight-milligram pills, mixed with two other ingredients, which can be purchased without a prescription. However, due to the opioid crisis witnessed by the country in recent years, pharmacists have been calling on the federal government to restrict access to over-the-counter codeine.

The College of Pharmacists of B.C. had previously expressed growing concerns about forged prescriptions and pharmacy robberies which targeted codeine formulations. In addition, there have been cases of codeine-containing medications diverted by health professionals for personal use or for illicit sale.  

In January 2020, codeine-containing medications of higher potency will be classified as controlled medications and require special, duplicate prescriptions. However, preparations containing low concentrations of codeine will remain available for over-the-counter sale at pharmacies.  

In his interview with the Vancouver Sun, Chris Chiew, general manager of western Canadian pharmacy operations for London Drugs, said that “grab and go” shoplifters are less likely to steal from stores with vaults used for storing codeine-containing medication because they would not want to wait for the vault to be unlocked.

Earlier in 2019, Health Canada conducted a safety review of cough and cold products containing opioids, including codeine, hydrocodone or normethadone.  The agency had concluded there was “limited evidence” linking codeine-containing cough syrups to opioid disorders and other harms in children and adolescents. However, Health Canada, still advised Canadians against the use of these products among children and adolescents under 18 years of age as a precautionary measure.

Another 2018 review of non-prescription medications containing codeine conducted by the Canadian Agency for Drugs and Technologies in Health (CADTH) found evidence that low-dose codeine is effective for pain control or chronic cough when compared with placebo or non-opioid analgesics.

The registrar of the College of Physicians and Surgeons, Dr. Heidi Oetter, told the Vancouver Sun that in addition to being potentially dangerous, codeine-containing cough medications have also not been shown to be effective for anything other than some pain relief. “The risk is simply too high for something that has no demonstrated benefits,” she said.

Earlier in May 2019, Saskatchewan’s College of Pharmacy Professionals released details of 15 charges against Dewdney Drugs, a pharmacy store in Regina. According to the results of an earlier inspection, during the period between April 2017 and January 2018, the Dewdney Drugs had purchased 1.6 million Tylenol 1 tablets, with 1.1 million of  bottles left unaccounted for. Subsequently, the owner of the pharmacy, a Regina pharmacist, had his licence suspended after being found guilty of professional misconduct and incompetence.

The Canadian Pharmacists Association had supported the move to of codeine-containing products to prescription status. The association is also calling on Health Canada to review the use of low-dose codeine due to evidence showing availability of better alternatives for pain management.

9 responses to “Cough syrups with codeine to become controlled medications

  1. Prohibiting OTC codeine preparations is precisely lead to the rise of the use of desomorphine (AKA krokodil) and harder, more dangerous and adulterated opioids found on the black market.

    This is an ill-advised and uninformed move that will only serve to drive more to suffer as they go on to consume the fentanyl-adulterated opioid products for sale on the street.

    This cannot go on forever.

    1. Sorry, I failed to mention the OTC codeine products ban I refer to was done in Russia some number of years ago.

  2. Here we go again. A century of prohibition and a half-century long war on drugs has yielded what? The drugs are cheaper, more plentiful and of a higher quality than ever before. Large multinational criminal organizations enjoy seemingly endless profits from their distribution and cash-strapped governments continue to waste taxpayer dollars funding violent militarized law enforcement agencies whose approach has been the violent repression and criminalization of large sectors of our society in their insane prosecution of this endless War on Drugs. And yet you would have us believe that this time you’re going to make prohibition work?!? That more regulation is again the answer? Do do you people even think about this stuff before he’s open your mouths??? Even just a little bit?? When will you ever learn?

    The perfectibility of man is a failed 19th century notion. If we are ever to get a handle on this issue it will require us having the moral courage to see this thing for what it actually is and to admit that we have made a series of terrible mistakes over the past 100 years. All of this, unfortunately, requires a degree of maturity which we as a species have very rarely shown.

  3. I suffer from intense bouts of bronchitis and pneumonia and have always been prescribed Novahistex (a codeine cough syrup) which I never refill nor get more than once a year. I called my dr and she told me first that she wouldn’t prescribe it and then that it was discontinued. Drs need to either find alternatives that work quickly or just fkn read patients charts like they’re supposed to and give people the medication they need.

  4. If anyone actually believes that Codeine has any bearing whatsoever on the opioid crisis they must have brain damage. As a long term opioid user I can attest that if someone is in enough pain and discomfort they will without a doubt turn to black market street drugs if necessary to alleviate their pain. Removing clean, adulterant free, low dose codeine based products from the shelves and screaming “Drug Seeker!” is not only insanity it is blatant stupidity and sadism from people who should know better than to demonize something that absolutely nobody is overdosing on. Now society within Canada has no choice but to turn to the cartels for help with our medications because you cannot even get a legitimate prescription for opioids anymore.

  5. I’m in the same situation- during extreme lower abdomen pain I have taken 2 hydromorphone tablets (2mg each) & yet felt no dizziness / nausea , neither did my pain subside. Canada has a broken healthcare system, with insensitive doctors

  6. Absolutely ridiculous. I or others in my family may use the occasional Tylenol 1 headache pill for different aches or pains, or a cough syrup occasionally for those crazy coughs that no other syrup works for. Yet others can smoke pot, or use other/get/ carry small amounts of other drugs in many other provinces without issue, and control oil becoming more lax. This is crazy that I or others would have to fight our doctor to prescribe these things for us, for the small but important uses we may need because someone things these contribute to the grand scheme of the drug addiction in our country.

  7. Don’t know why they want to pull it from shelves. It makes more sense keeping it there. Then at least people are taking actual codeine instead of god knows what. The government seriously needs to relax. They’ve been overstepping their boundaries way to much lately. It’s nobodies business but their own what they put into their body. Screw authoritarianism.

  8. First of all it is pretty scary that our government has no clue about the opioid epidemic. Nothing to do with codeine and also it doesn’t have the legal fentanyl. The drug killing every one is carfentanyl and synthetic heroin. The government is the reason I believe that fentanyl pills which weren’t approved by anyone when they removed Oxy 80’s as they were selling on the street. So look what that created

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