Codeine use, dependence and help-seeking behaviour in the UK and Ireland: an online cross-sectional survey

QJM. 2017 Sep 1;110(9):559-564. doi: 10.1093/qjmed/hcx076.

Abstract

Background: Codeine misuse and dependence poses a clinical and public health challenge. However, little is known about dependence and treatment needs in the UK and Ireland.

Aim: To characterize codeine use, dependence and help-seeking behaviour.

Design: An online cross-sectional survey advertised on Facebook, Twitter, health and drug websites and e-mail circulars.

Methods: The survey collected data on demographics and codeine use amongst adults from the UK and Ireland. The Severity of Dependence Scale measured the level of codeine dependence.

Results: The sample of 316 respondents had a mean age of 35.3 years (SD = 12.3) and 67% were women. Of the 316 respondents, 54 scored ≥5 on the Severity of Dependence Scale indicating codeine dependence (17.1%). Our study found that codeine dependence is a problem with both prescribed and 'over-the-counter' codeine. Codeine dependence was associated with daily use of codeine, faking or exaggerating symptoms to get a prescription for codeine and 'pharmacy shopping' ( P < 0.01). A higher number of respondents had sought advice on the Internet (12%) rather than from their general medical practitioner (GP) (5.4%). Less than 1% of respondents had sought advice from a pharmacist.

Conclusions: Codeine dependent users were more likely to seek help on the Internet to control their use of codeine than from a GP, which may indicate a potential for greater specialized addiction treatment demand through increased identification and referrals in primary care.

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Codeine* / adverse effects
  • Codeine* / therapeutic use
  • Cross-Sectional Studies
  • Drug Misuse* / prevention & control
  • Drug Misuse* / psychology
  • Drug Misuse* / statistics & numerical data
  • Female
  • General Practice / standards
  • General Practice / statistics & numerical data
  • Help-Seeking Behavior*
  • Humans
  • Internet / statistics & numerical data
  • Male
  • Middle Aged
  • Needs Assessment
  • Nonprescription Drugs / adverse effects
  • Nonprescription Drugs / therapeutic use
  • Opioid-Related Disorders* / diagnosis
  • Opioid-Related Disorders* / epidemiology
  • Opioid-Related Disorders* / psychology
  • Prescription Drugs / adverse effects
  • Prescription Drugs / therapeutic use
  • Severity of Illness Index
  • United Kingdom / epidemiology

Substances

  • Analgesics, Opioid
  • Nonprescription Drugs
  • Prescription Drugs
  • Codeine