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Dihydrocodeine
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== Regulation == ; Australia :In [[Australia]], dihydrocodeine is a 'pharmacist only' [[Standard for the Uniform Scheduling of Medicines and Poisons#Schedule 3: Pharmacist only medicine|Schedule 3]] drug, only when indicated for cough suppression, and compounded with one or more other therapeutically active substances not exceeding 15 mg dihydrocodeine per dose.<ref name=":0">{{Cite web|url=https://www.tga.gov.au/scheduling-decision-final/scheduling-delegates-final-decisions-june-2017|title=Scheduling delegate's final decisions, June 2017}}</ref> Schedule 3 drugs, while still OTC, can only be dispensed after consultation with a pharmacist. It is a [[Standard for the Uniform Scheduling of Medicines and Poisons#Schedule 4: Prescription only medicine|Schedule 4]] (prescription only) drug when compounded with one or more other therapeutically active substances and not exceeding 100 mg dihydrocodeine per dose.<ref name=":0" /> Any Dihydrocodeine preparation not falling within Schedules 3 or 4, including single ingredient dihydrocodeine preparations, are categorised as [[Standard for the Uniform Scheduling of Medicines and Poisons#Schedule 8: Controlled drug|Schedule 8]] (controlled drugs), which can only be dispensed in accordance with the stricter requirements of the state or territory in which they are prescribed (and which vary between states and territories).<ref name=":0" /><ref>{{cite journal | vauthors = Hua AC, Shen F, Ge X | title = State based legal requirement for Schedule 8 prescriptions: why so complicated? | journal = The Medical Journal of Australia | volume = 203 | issue = 2 | pages = 64–66 | date = July 2015 | pmid = 26175237 | doi = 10.5694/mja14.01587 | s2cid = 37916675 }}</ref><ref>{{cite web|title=Poisons Standard November 2016|url=https://www.legislation.gov.au/Details/F2016L01638/Html/Text#_Toc450920897|publisher=Australian Government|access-date=29 December 2016}}</ref> ; Hong Kong : In Hong Kong, dihydrocodeine is regulated under Schedule 1 of Hong Kong's Chapter 134 ''Dangerous Drugs Ordinance''. It can only be used legally by health professionals and for university research purposes. A pharmacist can dispense Dihydrocodeine when furnished with a doctors prescription. Anyone who supplies the substance without a prescription can be fined $10000 (HKD). The penalty for trafficking or manufacturing the substance is a $5,000,000 ([[Hong Kong dollar|HKD]]) fine and life imprisonment. Possession of the substance for consumption, without a licence from the Department of Health, is illegal and carries a $1,000,000 (HKD) fine or 7 years imprisonment. ; Japan : In Japan, dihydrocodeine is available without a prescription; used in cough medicines such as New Bron Solution-ACE. Dihydrocodeine is used as an antitussive in many products as a Dextromethorphan alternative. Medicines in Japan which contain dihydrocodeine are coupled with caffeine to offset the sedative effects and discourage recreational use. Cough medicines containing dihydrocodeine are controlled similarly to dextromethorphan in the United States, in that its sale is strictly limited by purchase quantity and is restricted to persons 20 and older for purchase. ; United Kingdom : In the United Kingdom, dihydrocodeine is a [[List of controlled drugs in the United Kingdom#Class B drugs|Class B]] drug; but, it is available over-the-counter in small amounts (less than 8 mg), when combined with [[paracetamol]] (see [[co-dydramol]]). Dihydrocodeine is listed in Schedule 5 of the Misuse of Drugs Regulations 2001 whereby it is exempt from prohibition on possession provided that it is in the form of a single preparation not being designed for [[Injection (medicine)|injection]] and less than 100 mg (calculated as [[free base]]) or with a total concentration less than 2.5% (calculated as [[free base]]). Illegal possession of dihydrocodeine can result in up to 5 years in prison or an unlimited fine. ; United States : In the US, pure dihydrocodeine is a [[Drug Enforcement Administration|DEA]] [[Controlled Substances Act#Schedule II controlled substances|Schedule II]] substance, although preparations containing small amounts of dihydrocodeine can also be classified as [[Controlled Substances Act#Schedule III controlled substances|Schedule III]] or [[Controlled Substances Act#Schedule V controlled substances|Schedule V]], depending on the concentration of dihydrocodeine relative to other active constituents, such as paracetamol (acetaminophen). The DEA's ACSCN for dihydrocodeine free base and all salts is 9120. The 2013 annual aggregate manufacturing quota is 250 kilos. International treaties and the controlled-substances laws of most countries, such as the German ''[[Betäubungsmittelgesetz]]'', regulate dihydrocodeine at the same level as codeine. Dihydrocodeine-based pharmaceuticals are especially used where chronic pain patients are able to have essentially OTC access to them provided they are registered with the provincial or national government as such a patient. Controlled-release dihydrocodeine is a non-prescription item in some places, especially the 60 mg strength. A report by the Ivo Šandor Organisation in 2004 listed Andorra, Spain, Gibraltar and Austria as having varying degrees of access to these and other dihydrocodeine, nicocodeine and codeine products.
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