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

Van Hout, Marie Claire and Horan, A and Santlal, K and Rich, E and Bergin, M (2017) ‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland. Qualitative Health Research , 27 , (3) , pp. 341-350.

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.


Item Type:Article
Date:July 2017
Page Range:pp. 341-350
Publisher:Sage
Volume:27
Number:3
EndNote:View
Related URLs:
Subjects:B Drugs and alcohol substances > Opioids (opiates) > Codeine
E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Over the counter drug (medicine / medication)
E Concepts in biomedical areas > Drugs and alcohol substance by legal status > Prescription drug (medicine / medication)
F Concepts in psychology > Attitude and behaviour > Attitude toward drugs and alcohol
J Health care, prevention and rehabilitation > Risk and protective factors > risk factors
J Health care, prevention and rehabilitation > Patient care management
T Demographic characteristics > Doctor
T Demographic characteristics > Pharmacist
VA Geographic area > Europe > Ireland

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