The Severity of Dependence Scale (SDS) for Codeine: Preliminary Investigation of the Psychometric Properties of the SDS in an Online Sample of Codeine Users From the UK

Abstract

Objective: Investigate the psychometric properties of the Severity of Dependence Scale (SDS) for codeine and its association with aberrant codeine related behaviors.Design: A voluntary and uncompensated cross-sectional online survey.Setting: Online population (≥18 years).Respondents: Two hundred and eighty-six respondents (66% women) who had used codeine containing medicines in the last 3 months and were living in the UK.Results: Of the respondents (mean age = 35.4 years, SD = 12.5), more than half were employed. Only 3.5% respondents reported no income. The majority of respondents (45.1%) primarily obtained prescription-only codeine from a consultation with a health professional, whilst 40.9% mainly purchased “over-the-counter” codeine containing medicines in a pharmacy without a medical prescription. Principal component analysis indicated a single factor solution accounting for 75% of the variance. Factor loadings ranged from 0.83 to 0.89. Cronbach's Alpha was high (α = 0.92). Several behaviors relating to codeine use were found to significantly predict probable codeine dependence. These included: daily codeine use in the last 3 months (OR = 66.89, 95% CI = 15.8–283.18); tolerance to codeine (OR = 32.14, 95% CI = 13.82–74.75); problems with role responsibility due to intoxication (OR = 9.89, 95% CI = 4.95–19.78); having sought advice on the internet to manage codeine use (OR = 9.56, 95% CI = 4.5–20.31); history of alcohol or drug treatment (OR = 3.73, 95% CI = 1.88–7.43).Conclusions: The SDS was acceptable and feasible to use to assess probable psychological codeine dependence in an online sample of people using codeine containing medicines. SDS scores were associated with behaviors known to be indicators of codeine dependence. Studies are needed in well-defined populations of people who use codeine to test the different aspects of psychometry of the scale compared against “gold standard” criterion [a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)].

Validity of severity of dependence scale-Indonesia in patients with drug and alcohol dependence

“…Cut-off points of specific substances are also established in regard to DSM-V dependence diagnosis, however further study is still required. The SDS-Ina is feasible as a self-reporting screening tool to measure the psychological dependence of substances, it is fairly easy and cost-effective to administer [16], [36]- [38]. Future studies should broaden the scope of the detection of illegal substances and addictive substances so that the effectiveness of SDS-Ina in screening suspected drug addiction patients in Indonesia will be better.…”

“…A brief self-reporting tool that is used globally is the severity of dependence scale (SDS). The instrument severity of dependence scale was developed by Dr. Michael Gossop in 1995 as a 1 minute and easily accessible scale to measure the degree of dependence experienced by various substance users [16]. It includes 5 questions; each relating to a different psychological component of dependence and is answered using a Likert scale from 0 being 'never' to a maximum of 3 being 'always'.…”

“I’m Not the Same Person Anymore”: Thematic Analysis Exploring Experiences of Dependence to Prescribed Analgesics in Patients with Chronic Pain in the UK

“…SDS scores have the potential range of 0–15 with a higher score indicating greater dependence severity [ 31 ]. The participants’ mean SDS score was 8.78 (range: 4–13, SD = 3.49) which indicated dependence using Deluca et al’s recommendation of a score of over 5 for codeine [ 32 ], a commonly prescribed painkiller [ 33 ]. All demographic information including chronic pain conditions and medications used can be found in Table 1 .…”

Operational definitions and measurement of externalizing behavior problems: An integrative review including research models and clinical diagnostic systems

“…Thus, although its items are based on the diagnostic criteria for nosotaxias, not all diagnostic criteria are operationalized in this instrument. This scale has been studied by adapting it to different drugs, and studies have confirmed its psychometric properties in users of heroin, cocaine, and amphetamine[ 11 ] alcohol[ 111 ], marijuana[ 112 , 113 ] ketamine[ 114 ] and codeine[ 115 ]. The Short Alcohol Dependence Data Questionnaire[ 116 ] assesses the severity of alcohol use disorder through 15 self-administered items.…”