Deputy Marian Harkin: In that context I am asking the Tánaiste if his Government will consider two things - to review the legislation and regulation around the sale of over-the-counter painkillers containing codeine and to look at the whole issue of pain management. It is not just enough to put regulation in place. We must also help people to deal with the issue of pain and chronic pain, which is a very significant concern for people all over the country. I can guarantee the Tánaiste that there are people sitting here in this Chamber today who know what that is. This is a big issue and I would like to hear a considered response from the Tánaiste.

The Tánaiste: I thank the Deputy. I will discuss this with the Minister of State, Deputy Feighan, and with the Minister, Deputy Donnelly, and will provide the Deputy with a more considered response a little bit later on. I had a chance to read the article about Laura Newell and her family in The Sligo Champion. I express my condolences to the family on Laura’s loss and to her two daughters aged 18 and 15 who have been left behind. I want also to express my thanks to the Newell family for being willing to talk about this issue as we do not talk enough about the issue of prescription drug addiction in Ireland. It is a very real problem. It is very sad to see that she started taking painkillers because her endometriosis had not been diagnosed. Endometriosis is frequently not diagnosed, which is a real shame, because once diagnosed, it can be treated very successfully. Unfortunately, that did not happen in her case.

Her story tells us something that all of us know which is that addiction can happen to anyone from any background or walk of life. It is very important that we recognise that the people who suffer from addiction need help. They should not be stigmatised or criminalised and they also need to be reassured that if they seek help, their medication will not be taken away from them, or that they will at least be given an alternative, which is very important.

Prescription drugs are a hidden addiction much of the time in Ireland. Sometimes it is codeine, other times it is benzos and other drugs. I had an opportunity over the past number of weeks to watch “Dopesick”. I am not sure if Members have seen that programme but it is about the OxyContin prescription drug dose epidemic in America. It is a different jurisdiction, a different drug and a different system but it gives a real insight into the problems that any country can have with prescription drugs where they are not properly regulated and are easily abused. It is based on a book called Empire of Pain which I have not as yet read but it is on my reading list.

On codeine, specifically, because of its potential for misuse, it is a controlled drug under the Misuse of Drugs Acts 1977 to 1984. Some low-dose preparations are currently available without prescription and are most commonly used in combination with other analgesics like paracetamol or ibuprofen for pain relief. Less frequently, it is used as a single ingredient cough suppressant. Low-dose preparations such as these are regulated as Schedule 5 controlled drugs. At the moment these drugs can all be sold in pharmacies under the personal supervision of a pharmacist and are not available for self-selection. The maximum dose of codeine in a non-prescription product is limited per the medical products regulations with the maximum daily dose authorised duration of no longer than three days. Pack sizes are limited as well. Codeine was a medicine that was very easily available over-the-counter in the past and it is more tightly regulated now. Somebody going into a pharmacy looking for codeine, Solpadeine or Nurofen Plus cannot just buy it and will be asked questions by the pharmacist but, perhaps, that is not enough. It is something that the Health Products Regulatory Authority, HPRA, will want to give further examination to.