Skip to main content Accessibility help
×
Home

Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply

  • V. I. O. Agyapong (a1), K. Singh (a2), M. Savage (a2), T. B. Thekiso (a2), M. Finn (a2), C. K. Farren (a1) and D. M. McLoughlin (a1)...

Abstract

Background

In 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.

Aims

To 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).

Methods

Participants completed a brief self-administered survey questionnaire about their use of over-the-counter codeine-containing medicines in the preceding 3 months.

Results

Compared 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).

Conclusion

We 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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply
      Available formats
      ×

Copyright

Corresponding author

*Address for correspondence: V. I. O. Agyapong, C/o Research Building, Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, James's Street, Dublin 8, Ireland. (Email israelhans@hotmail.com)

Footnotes

Hide All

This paper was presented orally and as an e-poster at the 20th European Congress of Psychiatry in Prague, Czech Republic, on the 4th of March 2012.

Footnotes

References

Hide All
Compton, WM, Volkow, ND (2006). Major increases in opioid analgesic abuse in the United States: concerns and strategies. Drug and Alcohol Dependence 81, 103107.
Dutch, MJ (2008). Nurofen Plus misuse: an emerging cause of perforated gastric ulcer. Medical Journal of Australia 188, 5657.
Ernest, D, Chia, M, Corallo, CE (2010). Profound hypokalaemia due to Nurofen Plus and Red Bull misuse. Critical Care and Resuscitation 12, 109110.
Forman, RF (2003). Availability of opioids on the internet. JAMA 290, 889.
Frei, MY, Nielsen, S, Dobbin, MD, Tobin, CL (2010). Serious morbidity associated with misuse of over-the-counter codeine-ibuprofen analgesics: a series of 27 cases. Medical Journal of Australia 193, 294296.
Hou, H, Yin, S, Jia, S, Hu, S, Sun, T, Chen, Q, Fan, R (2011). Decreased striatal dopamine transporters in codeine-containing cough syrup abusers. Drug and Alcohol Dependence 118, 148151.
Hastier, P, Buckley, MJM, Peten, PE, Demuth, N, Dumas, R, Demarquay, J-F, Caroli-Bosc, F-X, Delmont, J-P (2000). A new source of drug-induced acute pancreatitis: codeine. American Journal of Gastroenterology 95, 32953298.
Krausz, M, Degkwitz, P, Haasen, C, Verthein, U (1996). Opioid addiction and suicidality. Crisis 17, 175181.
Kreek, MJ, Bart, G, Lilly, C, LaForge, KS, Nielsen, DA (2005). Pharmacogenetics and human molecular genetics of opiate and cocaine addictions and their treatments. Pharmacologist Review 57, 126.
Lao, YZ, Jiang, ZY, Tong, ZS, Pang, ZT, Xu, JX (2010). Clinical features and defense styles in patients with cough medicine abuse. Medical Journal of Chinese People's Health 22, 272274.
Mattoo, SK, Basu, D, Sharma, A, Balaji, M, Malhotra, A (1997). Abuse of codeine-containing cough syrups: a report from India. Addiction 92, 17831787.
Peters, R Jr, Yacoubian, GS Jr, Rhodes, W, Forsythe, KJ, Bowers, KS, Eulian, VM, Mangum, CA, O'Neal, JD, Martin, Q, Essien, EJ (2007). Beliefs and social norms about codeine and promethazine hydrochloride cough syrup (CPHCS) use and addiction among multi-ethnic college students. Journal of Psychoactive Drugs 39, 277282.
Pharmaceutical Society of Ireland (PSI) (2010). Non-prescription medicinal products containing codeine: guidance for pharmacists on safe supply to patients (http://www.thepsi.ie/Libraries/Consultations/Final_Codeine_Guidelines.sflb.ashx). Accessed 20 June 2011.
Radat, F, Irachabal, S, Swendsen, J, Henry, P (2002). Analgesic abuse and psychiatric comorbidity in headache patients. Encephale 28(5 Pt 1), 466471.
Shek, DT, Lam, CM (2006). Adolescent cough medicine abuse in Hong Kong: implications for the design of positive youth development programs in Hong Kong. International Journal of Adolescent Medicine and Health 18, 493503.
Spillane, JF (2004). Debating the Controlled Substances Act. Drug and Alcohol Dependence 76, 1729.
Stock, CJ (1991). Safe use of codeine in the recovering alcoholic or addict. Drug Intelligence & Clinical Pharmacy 25, 4953.
Thekiso, T, Ahern, S, Farren, CK (2010). A study of ‘over the counter’ opiate abuse treatment. European Psychiatry 25, 1330.
Yang, Y, Yuan, QY (2008). Investigation and analysis on personalities of male-codeine phosphate addicts by MMPI. Chinese Journal of Drug Abuse Prevention and Treatment 14, 143145.

Keywords

Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply

  • V. I. O. Agyapong (a1), K. Singh (a2), M. Savage (a2), T. B. Thekiso (a2), M. Finn (a2), C. K. Farren (a1) and D. M. McLoughlin (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed