Buprenorphine-Naloxone in the Treatment of Codeine Dependence: a Scoping Review of Clinical Case Presentations

Hout, Marie Claire Van; Hearne, Evelyn; Bergin, Michael

doi:10.1007/s11469-016-9655-5

Cited by 1 publication

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References 45 publications

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“…[14,15,25] Availability of opioid agonists should probably be expanded to low-threshold services in the treatment of codeine dependence. [26] The training needs of treatment providers should be addressed as a matter of urgency to cover best practices for managing codeine misuse and dependence, including detoxification modalities, pharmacotherapy maintenance treatment, psychosocial support and ensuring proper aftercare. [24] Given the relatively low numbers of individuals in treatment for codeine-related problems [5] and the possible barriers that may make it harder for them to access treatment, active steps are needed, in particular to address denial of the problem and fear of being stigmatised.…”

Section: Recommendationsmentioning

confidence: 99%

Codeine misuse and dependence in South Africa: Perspectives of addiction treatment providers

et al. 2017

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Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. Method. Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions. Results. While many participants had received training in pharmacological management of individuals with opioid dependence, only two had received specific training on codeine management. Between half and two-thirds of the treatment settings they worked in provided detoxification, pharmacotherapy, psychosocial treatment and aftercare. Very few treatment settings offered long-term treatment for codeine misuse and dependence. Participants indicated that over half of their codeine patients entered treatment for intentional misuse for intoxication, and dependence resulting from excessive or long-term use. The main barriers to patients entering treatment were seen as denial of having a problem, not being ready for change, mental health problems, stigma, and affordability of treatment. Participants identified a need for further training in how to manage withdrawal and detoxification, treatment modalities including motivational interviewing, and relapse prevention. Conclusions. Gaps in training among treatment providers need to centre on how to manage withdrawal from codeine use and detoxification, motivational interviewing and relapse prevention. Interventions are needed to address barriers to entering treatment, including user denial.

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Section: Recommendationsmentioning

confidence: 99%

Codeine misuse and dependence in South Africa: Perspectives of addiction treatment providers

et al. 2017

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Buprenorphine-Naloxone in the Treatment of Codeine Dependence: a Scoping Review of Clinical Case Presentations

Abstract: Misuse of prescribed and over the counter (OTC) codeine containing medicines is an increasing public health concern in recent times. Studies have called for low threshold treatment services for individuals experiencing codeine dependence using buprenorphine

Cited by 1 publication

References 45 publications

Codeine misuse and dependence in South Africa: Perspectives of addiction treatment providers

Codeine misuse and dependence in South Africa: Perspectives of addiction treatment providers

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