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J Family Med Prim Care. 2017 Oct-Dec;6(4):867-869. doi: 10.4103/jfmpc.jfmpc_206_17.

A case report of over-the-counter codeine dependence as consequence of self-medication for premature ejaculation.

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Department of Psychiatry, Government Medical College, Thiruvananthapuram, Kerala, India.
Department of Psychiatry, Dr. Kunhalu's Nursing Home, Ernakulam, Kerala, India.
Department of Psychiatry, General Hospital, Ernakulam, Kerala, India.


Over-the-counter (OTC) opioid abuse, including codeine, has been a growing problem around the world. Although the majority of the abusers use it for recreational purposes, many become dependent on it after having used it a medication for pain or cough. We present a case of codeine dependence where the initial prescribed use had been as a cough medication, but the subsequent abuse of it occurred the following self-medication for premature ejaculation. There is growing need for awareness among doctors and pharmacists of OTC abuse of opioids and for preventive interventions such as restricting supply, audit of pharmacies, training pharmacists, and counter staff and dispensing knowledge about proper use of opioid-containing medications to patients.


Codeine dependence; over-the-counter; premature ejaculation

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