Extent of Codeine Substance Abuse in Singapore
Ministry of HealthSpeakers
Summary
This question concerns the prevalence of codeine abuse and measures to address it as raised by Mr Desmond Choo. Minister for Health Gan Kim Yong stated that the Health Sciences Authority restricts dispensing to 240 millilitres per patient every four days. The Singapore Medical Council disciplines doctors for errant prescribing, while enforcement agencies collaborate to curb illegal market diversion. Public education efforts aim to reduce demand, and between 2012 and 2016, thirty-seven offenders were convicted and five doctors disciplined. These multi-pronged strategies combine regulatory controls, professional oversight, and public awareness to mitigate addiction risks associated with codeine.
Transcript
21 Mr Desmond Choo asked the Minister for Health (a) how widespread is the abuse of codeine in Singapore; (b) which are the most vulnerable groups; and (c) what are the measures taken to address such codeine abuse in Singapore.
Mr Gan Kim Yong: Codeine is used as a medicine for the relief of cough and pain. As codeine can be addictive, the supply of medicines containing codeine is monitored and controlled in a few ways.
First, the manufacture, import and supply of medicines, including codeine cough preparations, is regulated by the Health Sciences Authority (HSA). Under HSA's Health Products Act, doctors and pharmacists can only supply to an individual patient not more than 240 millilitres of codeine cough preparation on any one occasion. They cannot supply to the same patient within a period of four days.
Any person who violates the law can be fined up to $50,000 and/or jailed for up to two years under the Health Products Act.
Second, as the professional body which regulates the conduct of doctors, the Singapore Medical Council (SMC) acts on complaints of errant prescribing or dispensation of codeine cough preparations. The SMC Ethical Code and Ethical Guidelines also provide guidance for doctors to prescribe or dispense drugs with potential for dependence or addiction. Doctors who breach the Ministry of Health's (MOH) guidelines or the SMC Ethical Code and Ethical Guidelines may face disciplinary action and be liable for suspension of between three months and a year, fine and censure.
Third, HSA regulates the wholesale distribution of codeine cough preparations, and works closely with various enforcement agencies, such as the Central Narcotics Bureau (CNB) and the Singapore Police Force (SPF) to curb the illegal diversion of such preparations into the illegal market.
Finally, to help reduce the demand for such preparations by codeine abusers and addicts, HSA has stepped up public education on the harm caused by codeine abuse through public advisories and press releases.
From 2012 to 2016, HSA convicted 37 offenders and SMC disciplined five doctors for inappropriate prescribing of codeine cough preparations.