Long orthopaedic waiting lists creating 'functional codeine addicts'

Olivia Kelleher

GP and Coroner in Donegal Dr Denis McCauley has said that waiting lists for orthopaedic surgery are so lengthy that they are creating "functional codeine addicts".

Yesterday fresh concerns were raised about the increasing use of painkillers containing codeine with prescriptions through the three main public drug schemes for such medicines having jumped by more than 22 per cent since 2012 to over one million prescriptions issued last year. The figures were released in a reply to a parliamentary question from Fine Gael's health spokesperson Colm Burke.

Deputy Burke said that data provided to him via parliamentary question shows that last year, 1,110,288 prescriptions were issued for codeine last year, which represents a 22 percent jump over the last ten years and a 17 percent increase since 2018.

Meanwhile, Dr McCauley told Today with Claire Byrne that he wasn't surprised at the figures which were released to Deputy Burke.

However, he said there was a number of explanations for the dramatic jump.

We are an ageing population. We are getting older and stiffer.

"Codeine is mainly used as a painkiller. We are an ageing population. We are getting older and stiffer.

"One of the main drugs in our armouries was an anti-inflammatory which we were advised over the last decade not to give to our elderly because it can have an effect on your kidneys and your heart. That has naturally been replaced by other medications. Codeine being one of them.

"The waiting list that we have... presently we have 65,000 (people) on a waiting list for orthopaedic outpatients and probable operations. These people we see every month. They are in severe pain. They are functional addicts now because we have to give them codeine to keep them going.

"We have to give stronger medication also. These are people who are taking codeine that probably shouldn't be. That is the way it is.

"Is there an issue with addiction of codeine? Yes there is. But the increase is primarily due to the other factors I would think.
During Covid we would have used a lot of codeine because it was really good for the cough. I do recognise the figures but there are numerous explanations for it."

Dr McCauley says he has seen patients "wait for years" for outpatient orthopaedic appointments for their knees.

"They come in and they are crying. You cannot but give them them medicines. We have all seen the documentary about Oxycontin, but there are patients on Oxycontin in Ireland for their knees and their hips because there is really nothing else we can give them.

"That is an indictment of the waiting lists rather than the patients. I don't want them to be victimised for that or for the doctors to be victimised for giving them the scripts because we have no option. 10 to 15 percent of our daily work is looking after people who are in pain waiting to be seen in hospital."

Pat Dalton, Pharmacist, and the owner of Dalton's Pharmacy in Cork city said members of the public who are intent on purchasing large amounts of codeine over the counter are going from chemist to chemist in order to obtain the medicine.

"At the moment we have no system for knowing if somebody is going to a large number of pharmacies purchasing over the counter counter.

"I strongly suspect it is going on. I hope it is not going on too much. We go through a list of questions with each patient and some people are very quick to come up with the answers. It is like they are pre prepared.

"If they present repeatedly you have got your evidence. If they have been attending multiple pharmacies I currently have no way of knowing that."