Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T08:17:08.214Z Has data issue: false hasContentIssue false

‘Over the counter’ (OTC) opiate abuse treatment

Published online by Cambridge University Press:  13 June 2014

Thekiso B Thekiso
Affiliation:
St Patrick's University Hospital, Dublin 8.
Conor Farren*
Affiliation:
St Patrick's University Hospital, Dublin 8, Ireland
*
*Correspondence E-mail: cfarren@stpatsmail.com

Abstract

Objectives: Over the counter (OTC) medication abuse is an increasing public health concern. We studied the clinical profiles, treatment and prevalence of patients admitted with OTC opiate abuse.

Method: Using a specially designed demographic form, the records of patients admitted to St. Patrick's Hospital, a 280 bed inpatient mental health and addiction treatment facility in Dublin, with a diagnosis of harmful OTC opiate abuse or opiate dependency as defined in ICD-10 were reviewed retrospectively. All patients diagnosed with OTC opiate abuse (ICD F11.1) or dependency (ICD F11.2) on admission to our centre were included in the study. Patients with a diagnosis of primary illicit opiate misuse were excluded.

Results: Approximately 1% (n=20) of inpatients admitted in a year were diagnosed with OTC opiate abuse. The average daily codeine intake was 261.0 mg per person. Some 75% percent (n=15) of the inpatients experienced OTC opiate withdrawal and were treated with protocol driven withdrawal regimes for an average of 16.10 days. The female: male ratio was nearly 2:1 with an average age of 49.2 years. Patients tended to have co-morbid psychiatric (n=19, 95%), physical (n=17,85%) and polysubstance (n=13,65%) illness.

Conclusions: OTC opiate abuse is a significant problem which is largely covert in nature with serious co-morbidity and frequent complications including withdrawal symptoms which require treatment. Results of this study suggest that further research is warranted in this area.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Ford, C, Good, B.Over the counter drugs can be highly addictive. British Medical Journal 2007; 334:917918.CrossRefGoogle ScholarPubMed
2.Carew, A, Bellerose, D, Lyons, S, Long, J.Trends in treated problem opiate use across Ireland, 2002–2007: Health Research Board; 2009.Google Scholar
3.Carise, D, Dugosh, K, McLellan, A, Camillieri, A, Woody, G, Lynch, K.Prescription OxyContin abuse among patients entering addiction treatment American Journal of Psychiatry. 2007; 164:17501756.Google Scholar
4.McCabe, S, Cranford, J, West, B.Trends in prescription drug abuse and dependence, co-occurrence with other substance use disorders, and treatment utilization: Results from two national surveys Addictive Behaviours 2008; 33:12971305.Google Scholar
5.McCabe, S, Cranford, J, Boyd, C.The relationship between past-year drinking behaviors and nonmedical use of prescription drugs: Prevalence of co-occurrence in a national sample. Drug and Alcohol Dependence. 2006; 84:281288.CrossRefGoogle ScholarPubMed
6.Porteous, T, Bond, C, Hannaford, P, Sinclair, H.How and why are non-prescription analgesics used in Scotland? Family Practice. 2005; 22:7885.CrossRefGoogle ScholarPubMed
7.World Health Organization. The Tenth Revision of the International Classification of Mental and Behavioural Disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.Google Scholar
8.Dyer, B, Martin, J, Sauven, N, Gazzard, B.Hypokalemia in Ibuprofen and codeine phosphate abuse. International Journal of Clinical Practice. 2004; 58:10611062.CrossRefGoogle ScholarPubMed
9.Kapusta, ND, Ramskogler, K, Hertling, I, et al.Epidemiology of substance use in a representative sample of 18-year-old males. Alcohol Alcohol. 03-04 2006; 41 (2):188192.CrossRefGoogle Scholar
10.Marsden, J, Gossop, M, Stewart, D, Rolfe, A, Farrell, M.Psychiatric symptoms among clients seeking treatment for drug dependence. British Journal of Psychiatry. 2000; 176:285289.CrossRefGoogle ScholarPubMed
11.de Beaurepaire, R, Lukasiewicz, M, Beauverie, P, et al.Comparison of self-reports and biological measures for alcohol, tobacco, and illicit drugs consumption in psychiatric inpatients. Eur Psychiatry. 11 2007; 22(8):540548.CrossRefGoogle ScholarPubMed
12.Kleinman, P, Miller, A, Millman, R, Psychopathology among cocaine abusers entering the treatment. Journal of Nervous and Mental Disorders. 1990; 178:442447.CrossRefGoogle Scholar
13.Darke, S, Topp, L, Ross, J.The injection of methadone and benzodiazepines among Sydney injecting drug users 1996–2000: 5 year monitoring of trends from the illicit Drug Reporting System. Drug and Alcohol Review. 2002; 21:2732.CrossRefGoogle ScholarPubMed
14.Rounsaville, B, Weissman, M, Kleber, M.Heterogenety of psychiatric diagnosis in treated opiate addicts. Archives of General Psychiatry. 1982; 39:161166.CrossRefGoogle Scholar
15.Liraud, F, Verdoux, H. [Clinical and prognostic characteristics associated with addictive comorbidity in hospitalized psychiatric patients]. Encephale. 05-06 2000; 26(3):1623.Google ScholarPubMed
16.Darke, S, Mills, K, Teesson, M, Ross, J, Williamson, A, Havard, A.Patterns of major depression and drug-related problems amongst heroin users across 36 months. Psychiatry Research. 2009; 166(714).CrossRefGoogle Scholar
17.Reay, G. Physical Dependence and Addiction to Prescription and Over the Counter Medication: Report on an Inquiry carried out by the All-Party Parliamentary Drug Misuse Group in the 2007–2008 Parliamentary Session.Google Scholar
18.Dobbin, M, Tobin, C.Over-the-counter ibuprofen/codeine analgesics: misuse and harm. Victoria, Australia, 05 2008.Google Scholar