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

van Hout, MC, Horan, A, Santlal, K, Rich, E and Bergin, M (2015) ‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland. Irish Journal of Psychological Medicine. ISSN 0790-9667

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Abstract

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. © College of Psychiatrists of Ireland 2015

Item Type: Article
Uncontrolled Keywords: 1701 Psychology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Public Health Institute
Publisher: Cambridge University Press (CUP)
Date Deposited: 21 Nov 2018 09:23
Last Modified: 21 Nov 2018 17:28
DOI or Identification number: 10.1017/ipm.2015.60
URI: http://researchonline.ljmu.ac.uk/id/eprint/9679

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