Opportunities and challenges: over-the-counter codeine supply from the codeine consumer’s perspective†

Nielsen, Suzanne; Cameron, Jacqui; Pahoki, Sanja

doi:10.1111/j.2042-7174.2012.00247.x

Cited by 41 publications

(72 citation statements)

References 12 publications

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“…Similar to studies in Australia, France and the UK Nielsen et al, 2013;Roussin et al, 2013;Cooper, 2013b) and SACENDU data in 2014 , daily use of codeine containing medicines for more than six months was common, and progressed within weeks of commencing use. Side effects of use were typically opioid related (constipating, stomach cramps, nausea, (Pates et al, 2002;Nielsen et al, 2010), and appeared grounded in the context of self-regulation vulnerabilities (Khantzian.…”

Section: Strategies For Preventionsupporting

confidence: 75%

“Codeine Is My Helper”

et al. 2016

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Misuse of codeine containing medicines is an emerging global public health concern. The majority of research has been conducted in developed countries (European Members States, Australia, United States). This study aimed to gain an understanding of unique individual and collective experiences of trajectories of codeine misuse and dependence in South Africa. In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents (n=25). Narratives were analyzed using the Empirical Phenomenological Psychological five step method. Nine themes with 63 categories emerged, with two additional high levels of abstraction. Findings are illustrated participant profile and product preferences; motives for use; transitioning to misuse and dependence; pharmacy purchasing and alternative sourcing routes; effects and withdrawal experiences; help-seeking and treatment experiences; and strategies for prevention. The study underscores the need for continued support for enhanced patient awareness of risk of habit forming use and related health consequences and professional pharmacovigilance.

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Section: Strategies For Preventionsupporting

confidence: 75%

“Codeine Is My Helper”

et al. 2016

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“…The study builds on findings reported in earlier qualitative studies with codeine dependents in the United Kingdom (Cooper, 2011(Cooper, , 2013a, Australia (Nielsen et al , 2013 and active online drug users (Van Hout, 2015). Given the covert nature of this issue, confounded by withdrawals, emotional distress and potential for serious co-morbidity, this study presents novel and meaningful illustration of the codeine misuse phenomenon, particularly within the Irish context.…”

Section: Discussionmentioning

confidence: 99%

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

Hout

Horan

Santlal³

et al. 2015

Ir. j. psychol. Med.

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Objectives. Global concern around over the counter availability of codeine containing products and risk of misuse, dependence and related harms are evident. A phenomenological study of lived experiences of codeine misuse and dependence was undertaken in Ireland, following the Pharmaceutical Society of Ireland's 2010 guidelines for restricted supply of non-prescription codeine containing products.Methods. In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents (n = 21), both actively using, in treatment and in recovery. The narratives were analysed using the Empirical Phenomenological Psychological five-step method (Karlsson, 1995). A total of 10 themes with 82 categories were identified. Two concepts at a higher level of abstraction above the theme-level emerged during the final stage of analysis. The concepts identified were 'emotional pain and user self-legitimization of use' and 'entrapment into habit-forming and invisible dependent use'. These concepts were reported in different ways by a majority of participants.Results. Findings are presented under the following themes: (1) profile and product preferences; (2) awareness of habit forming use and harm; (3) negotiating pharmacy sales; (4) alternative sourcing routes; (5) the codeine feeling; (6) the daily routine; (7) acute and chronic side effects; (8) social isolation; (9) withdrawal and dependence and (10) help-seeking and treatment experiences.Conclusions. There is a public health and regulatory imperative to develop proactive responses tackling public availability of codeine containing medicines, risk minimisation in consumer self-treatment for pain, enhanced patient awareness of potential for habit forming use and its consequences and continued health professional pharmacovigilence.

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“…Agyapong et al (2013) observe the potential for positive outcomes in deterrence of misuse of codeine following regulatory restrictions on visibility of products to the customer, restricted supply and pharmacist interventions at point of sale in Ireland. Of concern is that despite such proactive guidelines for restricted sales, relative ease of purchasing is reported by individuals misusing codeine containing products, with refusal at one pharmacy contributing to patterns of 'pharmacy hopping' (Nielsen, Cameron, & Pahokia, 2013;Van Hout, 2014b). These studies also describe customer tactics in securing a successful purchase as centring on appropriate appearance and pre rehearsed scripts in the event of pharmacist interrogation.…”

Section: Detection and Reduction Of Risk Of Codeine Misuse And Dependmentioning

confidence: 94%

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

Hout

Norman

2016

International Journal of Drug Policy

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Opportunities and challenges: over-the-counter codeine supply from the codeine consumer’s perspective†

Cited by 41 publications

References 12 publications

“Codeine Is My Helper”

“Codeine Is My Helper”

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

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

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