Effective from 1st December 2024, French pharmacies will only be permitted to dispense the popular opioid-based painkillers codeine and tramadol upon proof of a valid and secure prescription. This move is part of a national effort to reduce cases of abuse and long-term dependence.
France’s National Agency for the Safety of Medicines and Health Products (ANSM) has introduced new restrictions on the frequently prescribed pain medications codeine and tramadol.
As of 1st December, medicines containing tramadol, codeine, and dihydrocodeine, alone or in combination with other pain relievers such as paracetamol and ibuprofen, will only be dispensed upon presentation of a secure prescription, also called a protected order. The prescriber must clearly state the dosage and specify a treatment duration that lasts no more than 12 weeks. After this period, the patient must obtain a new prescription.
The term “secure prescription” differs from a regular one in that it must meet certain standards to prevent forgery. These include being pre-printed in blue with a watermark on paper free of optical brighteners, and with a minimum weight of 77 g/m². Pharmacists are trained to recognise false prescriptions and are now actively working to reduce instances of fraud, counterfeiting, the use of false documents, and theft.
The dangers of opioid overuse
For all practical purposes, codeine and tramadol offer the same basic level of relief, as both belong to the opioid family. The difference is that codeine is a natural opiate derived from the opium poppy plant, while tramadol is a synthetic, man-made drug.
Both options can be addictive, and taking more than the recommended dose can lead to death or serious injury. According to a 2023 study by the UK’s National Institutes of Health, deaths from codeine in France have decreased since 2017, while tramadol-related fatalities are on the rise.
Side effects are similar, with patients reporting mild symptoms such as light-headedness, dizziness, nausea, vomiting, shortness of breath, constipation, abdominal pain, itching, and rashes. More serious side effects include hallucinations, confusion, and trouble urinating.
For more information on the new law, as well as recommended usage and precautions, click here.
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