BackgroundIn recent years, concerns have been highlighted in several jurisdictions, including Ireland, regarding abuse of over-the-counter codeine-containing medicines. On the 1st of August 2010, national regulatory guidelines aimed at limiting the supply of these medicines in Ireland came into force.AimsTo study the effects of the new regulations on the use of non-prescribed codeine-containing medicines by psychiatric patients admitted to an Irish university teaching hospital before (n = 117) the regulations came into effect and 6 months afterwards (n = 126).MethodsParticipants completed a brief self-administered survey questionnaire about their use of over-the-counter codeine-containing medicines in the preceding 3 months.ResultsCompared with before the introduction of the new regulations, there was a large decline in the reported ‘often’ or ‘regular’ use of codeine-containing medicines in the 3 months before admission (33.3% v. 17.4%, χ2 = 6.354, p = 0.01) and there was a reduction in the proportion of patients for whom others had expressed concerns about their frequency of use of such medications (15.5% v. 4.8%, χ2 = 7.29, p = 0.03). There was also a decline in the proportion of patients who stated that they would use codeine-containing medicines for either a ‘feel-good’ effect or to curb cravings (15.9% v. 1.9%, p < 0.01, two-tailed Fisher's exact test).ConclusionWe conclude that tight regulations on the supply of non-prescription codeine-containing medicines have the potential to reduce the use and abuse of such medicines in patient populations availing of admission to psychiatry hospitals.

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Background: On the 1 st of August 2010 guidelines aimed at ensuring the safe supply of over-the-counter codeine containing medicinal products came to force in Ireland. Objectives: The study aimed to examine the frequency of use as well as reasons for the use of non-prescription codeine containing medicines in an Irish psychiatric population before and after the introduction of regulations on the supply of codeine containing medicines. Methods: Self administered questionnaires were designed and administered to patients before and after the introduction of guidelines regulating the sale of non-prescribed codeine containing medicines in Ireland. The results were compiled and analysed using descriptive statistics and chi-square test. Results: Significantly more patients reported that they often or regularly used codeine containing medicines before the introduction of the regulation compared to the period after that(33.3% vs. 17.4%, x2= 6.354, p=0.01). Significantly more patients also reported that others had expressed concerns about the frequency with which they used codeine containing medicines before the introduction of the regulation compared to the period after the introduction of the regulation (15.5% vs. 4.8%, x2= 7.29, p=0.03). Finally, significantly more patients stated that they would use codeine containing medicines either for the 'feel good' effect or to curb cravings before the introduction of the regulation than after the introduction of the regulation (15.9% vs. 1.9%, p=0.00). Conclusion: Tight regulations on the supply of non-prescription codeine containing medicines have the potential to reduce the abuse of such medicine among psychiatric patients in general.