Transcript Oral Presentation 1

REDUCING CODEINE
COUGH SYRUP MEDICINE
CONSUMPTION TO
CONTROL CODEINE ABUSE
IN THAILAND
Background
 Codeine is one of narcotics due to it’s
biological property of drug dependence.
 The Codeine cough syrup medicine
has been classified as
Narcotic
in schedule III
 Extensive abuse of the Codeine cough
syrup medicine has been recognized
through the mass media.
Notifications of the Ministry of Public Health
(December A.D. 2002)
 No.179 : To reduce the total usage of codeine
to be used for medicinal and scientific
purposes throughout the Kingdom to 1,000
kg within the year A.D.2003
 No.180: To set a strict control over the
manufactured or imported quantity of the
codeine containing preparation
 No.181: Specify the amount of Codeine
containing preparation which could be
suspected that possess for dispose
Ministerial Regulation
(June A.D. 2003)
 To allow the disposal of the codeine
containing preparations only in
the private hospitals and Government
healthcares
Control of the Codeine cough syrup medicine disposal
Prosecution
Penalty
Importers
Manufacturers
Distributors
Reports of total disposal monthly
Food and Drug Administration (FDA)
Incorrect data
Randomly examine the reports
regularly
Drug stores
Clinics
Hospitals
Objective
 To examine codeine cough syrup
medicine disposal before and after
launching the Notifications and
Ministerial Regulation of the Ministry
of Public Health
Methods
 Using surveillance data (the reports to
FDA monthly)
 Trend of codeine cough syrup
medicine disposal from July 2000 to
November 2003
 Stratifications of Codeine distributions
 by areas
 types of healthcare sectors
Stratification
 By areas





Bangkok Metropolis
Central Region( 25 Provinces)
NorthEastern Region ( 19 Provinces)
Northern Region ( 17 Provinces)
Southern Region ( 14 Provinces)
 By types of health care services
 Drug stores
 Clinics
 Hospitals
Results
Trend of Codeine cough syrup medicine consumption in
ml/month/1000 population from July A.D.2000 to Nov.A.D.2003
1400.0
ml_1000 population
1200.0
1000.0
800.0
This is where a large graphic or chart can go.
600.0
400.0
200.0
0.0
Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov00 00 00 00 00 00 01 01 01 01 01 01 01 01 01 01 01 01 02 02 02 02 02 02 02 02 02 02 02 02 03 03 03 03 03 03 03 03 03 03 03
Consumption of Codeine cough syrup medicine in ml/month/1000
population by area in A.D.2000 to A.D.2003
ml/month/1000 population
3500
3000
BKK
2500
Central
2000
NE
This is where a large graphic or chart can go.
North
1500
south
1000
500
0
year
2000
2001
2002
2003
Average volume of Codeine cough syrup medicine distribution in
Litre per month by types of healthcare services
in A.D.2000 to A.D.2003
Litre/month
45000
40000
35000
30000
This is where a large graphic or chart can go.
25000
hospital
drugstore
20000
clinic
15000
10000
5000
0
year
2000
2001
2002
2003
Implications/Conclusions
 The Notifications and Ministerial Regulation
effectively reduced the disposal of Codeine
cough syrup medicine, especially
 the high risk areas (of abuse)
 Bkk and the southern part
 the high risk health sectors (of abuse)
 drugstores and clinics
 The result reflexes effective control of
Codeine abuse (Cough syrup preparation)?
 The policy should be continued to eradicate the
abuse.
 The impact on codeine use in medical
practice such as analgesic and anti- cough
(from the policy) should be considered and
minimized.
Future studies recommended
 To minimized impact on medical use
 Impact in black market
 Prevalence of Codeine abuse in high
risk groups
 Establishing clinical guideline on
Codeine used
 Shift of substances to substitute
Codeine
Thank you