I want to raise a very difficult issue with the Tánaiste this morning which relates to the overuse of and in some cases addiction to over-the-counter medication, in particular, those medications which contain codeine. The context in which I am raising this is the death of a young 39-year-old woman at Sligo University Hospital just over two weeks ago. That happened because of her addiction to over-the-counter opioid-containing medication. Her name was Laura Newell and her sad and untimely death has been reported in many newspapers. The reason I am raising this with the Tánaiste is that her sister, whom I know, wrote to me and, indeed, to all of the public representatives in the Sligo-Leitrim Constituency, and asked us to raise the issue of dependence on and addiction to over-the-counter painkillers in Ireland. She specifically stated, “I await your response in the hope that my family can rely on you to raise these concerns at the highest level.” She went on to state, “My hope would be that legislation could be put in place that will remove the medicine from behind the counter and be available ... only through consultation with the GP.”

It is a long email and it is heart-breaking because it tells how the 39-year-old woman died painfully from addiction. Her sister names the over-the-counter medication. I will not do so here, but it is a household name. There is nothing extraordinary about Laura Newell’s sad story but her addiction started as a response to the need for pain medication due to undiagnosed endometriosis. In order to try to deal with her pain, she started taking over-the-counter opioid medication. As her sister said, the drugs she was addicted to are legal and easy to obtain. She said that she was buying them from chemists throughout the county and further afield. Recently, she started accessing them online from pharmacies across Ireland. She said that these purchases are unregulated and make it easy for addicts to access opioid medicines. There is much more in it and it is a sad email but the core of this is that her family have decided to be quite candid about her death. As her sister said, if there is to be any sense out of her loss, it would be the prevention of any other family going through this experience.

In that context I am asking the Tánaiste if his Government will consider two things - to review the legislation and regulation around the sale of over-the-counter painkillers containing codeine and to look at the whole issue of pain management. It is not just enough to put regulation in place. We must also help people to deal with the issue of pain and chronic pain, which is a very significant concern for people all over the country. I can guarantee the Tánaiste that there are people sitting here in this Chamber today who know what that is. This is a big issue and I would like to hear a considered response from the Tánaiste.

I thank the Deputy. I will discuss this with the Minister of State, Deputy Feighan, and with the Minister, Deputy Donnelly, and will provide the Deputy with a more considered response a little bit later on. I had a chance to read the article about Laura Newell and her family in The Sligo Champion. I express my condolences to the family on Laura’s loss and to her two daughters aged 18 and 15 who have been left behind. I want also to express my thanks to the Newell family for being willing to talk about this issue as we do not talk enough about the issue of prescription drug addiction in Ireland. It is a very real problem. It is very sad to see that she started taking painkillers because her endometriosis had not been diagnosed. Endometriosis is frequently not diagnosed, which is a real shame, because once diagnosed, it can be treated very successfully. Unfortunately, that did not happen in her case.

Her story tells us something that all of us know which is that addiction can happen to anyone from any background or walk of life. It is very important that we recognise that the people who suffer from addiction need help. They should not be stigmatised or criminalised and they also need to be reassured that if they seek help, their medication will not be taken away from them, or that they will at least be given an alternative, which is very important.

Prescription drugs are a hidden addiction much of the time in Ireland. Sometimes it is codeine, other times it is benzos and other drugs. I had an opportunity over the past number of weeks to watch “Dopesick”. I am not sure if Members have seen that programme but it is about the OxyContin prescription drug dose epidemic in America. It is a different jurisdiction, a different drug and a different system but it gives a real insight into the problems that any country can have with prescription drugs where they are not properly regulated and are easily abused. It is based on a book called Empire of Pain which I have not as yet read but it is on my reading list.

On codeine, specifically, because of its potential for misuse, it is a controlled drug under the Misuse of Drugs Acts 1977 to 1984. Some low-dose preparations are currently available without prescription and are most commonly used in combination with other analgesics like paracetamol or ibuprofen for pain relief. Less frequently, it is used as a single ingredient cough suppressant. Low-dose preparations such as these are regulated as Schedule 5 controlled drugs. At the moment these drugs can all be sold in pharmacies under the personal supervision of a pharmacist and are not available for self-selection. The maximum dose of codeine in a non-prescription product is limited per the medical products regulations with the maximum daily dose authorised duration of no longer than three days. Pack sizes are limited as well. Codeine was a medicine that was very easily available over-the-counter in the past and it is more tightly regulated now. Somebody going into a pharmacy looking for codeine, Solpadeine or Nurofen Plus cannot just buy it and will be asked questions by the pharmacist but, perhaps, that is not enough. It is something that the Health Products Regulatory Authority, HPRA, will want to give further examination to.

I thank the Tánaiste. We all deeply sympathise with the family of Laura Newell. The purpose of this discussion is to ask what can be done about it and how can we prevent it happening again. Her sister talked to me about what happened in Australia. That country banned over-the-counter painkiller medication in 2018 and it has worked for that country. It has not caused many of the problems that the people there thought it might cause. I would like to hear, if not today but certainly very soon, that this Government will examine this issue and look at the possibility of doing that.

When I was a Member of the European Parliament, I chaired the pain group and we were involved with the WHO in ensuring that for the first time two years ago pain was seen as a disease in its own right as distinct from a symptom of another disease. One of the issues we face is that pain management is woefully under-resourced in this country.

A two-pronged approach is needed. I hope the Tánaiste can give me some positive indication that he will consider that.

I will have to double-check with the Minister for Health and the Minister of State, Deputy Feighan, as to exactly what the legal position is on this matter. There are two regulators in this area, as the Deputy knows. The Pharmaceutical Society of Ireland regulates pharmacists and is responsible for making sure that pharmacists do not hand out these medicines too easily, while the Health Products Regulatory Authority is responsible for the regulation of medicines, including controlled drugs such as these. I am not sure if it is a ministerial or Government decision or a regulatory one but I will look into it and come back to the Deputy in a few weeks with something a bit more solid.