A cross‐sectional analysis of over‐the‐counter codeine use among an Australian sample of people who regularly inject drugs

Abstract

There is a need to evaluate the approach to pain management in this population. Greater pharmacist involvement, real-time monitoring of sales, the development of screening tools to identify those at risk of harm and further education of primary care practitioners could be beneficial in reducing the risk of harm associated with these medications for all users of OTC codeine, including people who inject drugs.

Patterns and correlates of non-fatal heroin overdose at 11-year follow-up: Findings from the Australian Treatment Outcome Study

“…The latter is of particular interest, as it represents a change in the behaviour of the cohort that is consistent with broader concerns about the abuse of pharmaceutical opioids (Arora et al, 2013;Cicero et al, 2014). As baseline, these drugs were not amongst the most commonly used substances by the cohort, whereas they are now amongst the top five.…”

Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies

“…Misuse of products containing codeine can occur following initial legitimate therapeutic use of the drug for the treatment of pain and also from initial non-therapeutic use, where the drug is consumed to produce intoxication (Frei et al, 2010;McDonough, 2011;Van Hout, 2014b;Van Hout et al, 2014) with studies observing the interplay between self-medication, chronic pain and iatrogenic dependence (Arora, Roxburgh, Bruno, Nielsen, & Burns, 2013;Hamer, Spark, Wood, & Roberts, 2014;Roussin, Pouche, Pourcel, & Lapeyre-Mestre, 2013). Misuse and dependence occurs in a wide range of groups, with studies reporting on parental medication of children (Allotey, Reidpath, & Elisha, 2004), recreational users (Agnich, Stogner, Miller, & Marcum, 2013;Ford & Good, 2007;Lam & Shek, 2006;Peters et al, 2003;, Peters, Williams, Ross, Atkinson, & Yacoubian, 2007, Peters, Amos, et al, 2007Van Hout, 2014a, 2014b, university students (Acocella, 2005), pharmacy customers (Albsoul-Younes, Wazaify, Yousef, & Tahaineh, 2010;Sweileh, Arafat, Al-Khyat, Al-Masri, & Jaradat, 2004), older people (Agaba, Agaba, & Wigwe, 2004;Roumie & Griffin, 2004), psychiatric patients (Agyapong et al, 2013), injecting drug users (Arora et al, 2013), non-treatment seeking individuals (Nielsen, Cameron, & Lee, 2011) and drug treatment patients (Akram and Roberts, 2003;Cohen, Unoh, Barry, & O'Connor, 2009;Cooper, 2013c;Myers, Siegfried, & Parry, 2003;Nielsen et al, 2008;Nielson et al, 2010;Thekiso & Farren, 2010;...…”

A Comparative Exploration of Community Pharmacists’ Views on the Nature and Management of Over-the-Counter (OTC) and Prescription Codeine Misuse in Three Regulatory Regimes: Ireland, South Africa and the United Kingdom

“…Reinforcers for problematic consumption include use relating to intoxicating purposes and when benefits of misuse outweigh adverse consequences (Casati, Sedefov et al 2012). The interplay between chronic non-cancer pain, self-medication of codeine and iatrogenic dependence has also been observed (Arora, Roxburgh et al 2013;Roussin, Bouyssi et al 2013;Hamer, Spark et al 2014). Reported health consequences from long term and/or excessive misuse of combination codeine analgesics include headaches, nephrotoxicity, gastro-intestinal conditions, hypokalaemia, acute haemorrhagic and necrotizing pancreatitis (Dyer, Martin et al 2004;Dutch 2008;Ernest, Chia et al 2010;Evans, Chalmers-Watson et al 2010;Frei, Nielsen et al 2010;McDonough 2011;Pilgrim, Dobbin et al 2013;Pilgrim and Drummer 2014).…”