Experts are calling for tough new restrictions on a popular painkiller after revelations more than 100 deaths in Victoria have been linked to the over-the-counter pills.
Melbourne researchers who combed a decade of coroner's data found 115 cases where codeine and ibuprofen were both detected, including 63 examples where drug toxicity was the cause of death.
There are six painkillers on the market in Australia that contain ibuprofen and codeine - the most popular of which is Nurofen Plus.
Nine cases between 2001 and 2011 could be directly linked to the horrific internal damage caused by long-term misuse of the anti-inflammatory drug, including gastric erosions and ulceration.
Some people have been known to take up to 70 of the tablets a day, travelling from chemist to chemist to fuel their habit, despite 2010 laws limiting the size of doses available.
Researcher at Monash University's Department of Forensic Medicine, Jennifer Pilgrim, co-wrote the new study and explained that while ibuprofen was the ingredient that caused the deaths it was the codeine that created the addiction.
It is for that reason the study's authors, including Monash University's head of forensic medicine, have called for the pill to be restricted to prescription-only or for codeine to be completely removed from Nurofen Plus and similar products.
Dr Pilgrim said the alternative was increased monitoring by the chemists to keep track of the quantity of drugs purchased by each individual.
"All those options involve more input from prescribers and the pharmacist, but that is the only way the situation is going to be managed,' she said.
One death that came before the Victorian coroner was a 48-year-old woman who had already been identified as a "doctor shopper" and had restricted access to prescription medicines. Unfortunately Dr Pilgrim said she was still able to buy boxes of Panafen Plus at several pharmacies.
"The Coroner actually made a point of saying the problem in this case is the (drugs) that she can access over the counter quite easily were the ones that killed her," Dr Pilgrim said.
Due to limitations of the coroner's data, researchers said it was likely the numbers of deaths linked to the over-the-counter tablets had been underestimated. However they are not sure by how much.
Dr Pilgrim said the researchers generally did not have access to the prescription history of the deceased and sometimes by the time the person had died the drug could no longer be detected in the body.
While the most recent study published in the Medical Journal of Australia only examined Victorian cases, Dr Pilgrim said they were looking at expanding the survey to the rest of Australia.