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  1. REDUCING CODEINE COUGH SYRUP MEDICINE CONSUMPTION TO CONTROL CODEINE ABUSE IN THAILAND

  2. 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.

  3. 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 kgwithin 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 preparationwhich could be suspected that possess for dispose

  4. Ministerial Regulation(June A.D. 2003) • To allow the disposal of the codeine containing preparations only in the private hospitals andGovernment healthcares

  5. Control of the Codeine cough syrup medicine disposal Importers Manufacturers Distributors Prosecution Penalty Reports of total disposal monthly Food and Drug Administration (FDA) Incorrect data Randomly examine the reports regularly Drug stores Clinics Hospitals

  6. Objective • To examine codeine cough syrup medicine disposal before and after launching the Notifications and Ministerial Regulation of the Ministry of Public Health

  7. Methods

  8. 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

  9. 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

  10. Results

  11. Trend of Codeine cough syrup medicine consumption in ml/month/1000 population from July A.D.2000 to Nov.A.D.2003 This is where a large graphic or chart can go.

  12. Consumption of Codeine cough syrup medicine in ml/month/1000 population by area in A.D.2000 to A.D.2003 This is where a large graphic or chart can go.

  13. Average volume of Codeine cough syrup medicine distribution in Litre per month by types of healthcare servicesin A.D.2000 to A.D.2003 This is where a large graphic or chart can go.

  14. Implications/Conclusions

  15. 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

  16. 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.

  17. 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

  18. Thank you