Over The Counter (OTC) medication abuse is an increasing yet under-researched public health concern, particularly in the UK and Ireland. Our study provides a descriptive analysis of the clinical profiles; treatment and prevalence of patients admitted with OTC opiate abuse.

Using a specially designed demographic form, the records of patients admitted to St. Patrick's Hospital, a 280 bed inpatient mental health and addiction treatment facility in Dublin, Ireland with a diagnosis of harmful OTC opiate abuse or opiate dependency as defined in ICD-10 were reviewed retrospectively. All patients diagnosed with OTC opiate abuse (ICD F11.1) or dependency (ICD F11.2) on admission to our centre were included in the study. Patients with a diagnosis of primary illicit opiate misuse were excluded. Diagnoses were established by a consultant psychiatrist.

Approximately 1% (n=20) of inpatients admitted in a year were diagnosed with OTC opiate abuse. The average daily codeine intake was 261.10 mg per person. Seventy five percent (n=15) of the inpatients experienced OTC opiate withdrawal and were treated with protocol driven withdrawal regimes for an average of 16.10 days. The female: male ratio was nearly 2:1 with an average age of 49.2 years. Patients tended to have comorbid psychiatric (n=19, 95%), physical (n=17, 85%) and polysubstance (n=13, 65%) illness. The relapse rate of re-admissions within six months of discharge was 35%.

OTC opiate abuse is a covert illness since abusers often have significant comorbid psychiatric, medical and polysubstance illness making its assessment, diagnosis and subsequent treatment challenging.