How to fight opioid addiction? The National Medicines Safety Agency (ANSM) announced on Thursday September 26 new measures to combat prescription fraud: tramadol and codeine must be prescribed on a so-called “secure” prescription, that is to say theoretically tamper-proof, as of December 1st.
Codeine and tramadol are two opioids prescribed for pain. Taken in too large quantities, they can become addictive. Despite several measures already taken to reduce the risk of addiction, such as the marketing of boxes containing fewer tablets and the reduction in the maximum prescription duration of tramadol, these two drugs continue to claim victims. In 2022, tramadol caused 18 deaths while codeine caused six deaths.
The national medicines safety agency therefore wishes to better control access to these medicines. Especially since according to Philippe Vella, medical director at the ANSM, in 2022, “ of approximately 2,600 falsified prescriptions, 457 concerned tramadol, 416 codeine for its antitussive specialties and 293 for indications against pain».
A watermark representing a caduceus
Secure orders appeared in France in 1999 with the publication of a decree relating to “poisonous substances and the organization of the evaluation of drug dependence”. They can only be written by healthcare professionals on specific prescriptions that only approved printers are authorized to produce.
It includes pre-printed information such as the doctor’s surname, first name, identification number, telephone number and address. They also have an anti-fraud barcode.
The patient’s first and last name must also be included. The prescriber must have written in full the dosage, dosage and duration of treatment. A watermark representing a caduceus as well as microletter squares are intended to make forgery more difficult.
The secure prescription also limits the duration of prescription, generally 28 days but this period can be shorter (14 or even only seven days) for certain narcotic products. For narcotics or similar drugs, when the prescribed treatment has not been collected within three days in a pharmacy, then the quantities dispensed will be reduced to cover only the remaining period.
Before tramadol and codeine, several types of medications were already subject to this particular type of prescription. This is the case for certain opioids (such as morphine), psychotropic drugs (certain antidepressants and antipsychotics) or narcotics.
