Blog - Codeine and Drug Testing

Codeine chemical structure

Codeine is an opiate analgesic, used for the treatment of moderate to severe pain that does not respond to aspirin, paracetamol or ibuprofen alone. It is available in a wide range of over-the-counter preparations for pain and fever in combination with paracetamol (e.g. Panamax Co) or ibuprofen (Nurofen Plus). Some forms of codeine are only available by prescription (e.g. Panadeine Forte). In addition, codeine is a cough suppressant and may be available in prescription-only cough medicines.

Workplace testing of both oral fluids and urine commonly results in non-negative detection of the opiate class of drugs, attributable to self-medication or prescribed use of codeine. These are confirmed by laboratory analysis and usually demonstrate the presence of both codeine and morphine (produced in the body from codeine).

Workplace Responsible Managers sometimes face difficulties with responding to on-site non-negative test results for opiates. Some workplace policies allow the worker to remain at work if, in the judgement of the Responsible Manager and if they confirm that they have taken codeine products, they are fit for normal or alternative duties. Other workplaces will automatically stand down the donor pending confirmation testing, resulting in donors taking unnecessary time away from work, when they have taken codeine products and are fit for work.

This potential dilemma may be resolved when products containing codeine will be available only by prescription from 1 February 2018. This decision aligns Australian availability of codeine with that in most of Europe, the USA, Japan and other countries. A Regulation Impact Statement and modelling of economic, social and regulatory impacts found that up-regulating to prescription only would

“… result in reduced deaths from accidental or deliberate codeine overdose, improved quality of life, and reduced codeine dependence and reduced risk of dependency.”

Changes to workplace drug and alcohol policies to require workers to present a copy of their prescription if they claim to be using codeine will reduce the incidence of worker absence due to codeine use. It will also reduce the use of codeine by some workers as a way to gain paid leave while awaiting laboratory confirmation testing.

You can access further information about Codeine from the Therapeutic Goods Administration. The codeine rescheduling announcement can be found here.

 Boilerplate John