Acta Pharm. 65 (2015) 351-364

 

full paper

Mini-review

 

Practice implications and recommendations for managing codeine misuse and dependence

MICHAEL BERGIN, IAN NORMAN, MICHELLE FOLEY, RICHARD HARRIS, ANNA RAPCA, EILEEN RICH and MARIE-CLAIRE VAN HOUT

mcvanhout@wit.ie

1 Ph.D. School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland

2 Ph.D. Kings College London, Florence Nightingale Faculty of Nursing & Midwifery, London, United Kingdom

3 School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland

4 H.I. Weldrick Ltd, Doncaster, United Kingdom

5 Alcohol, Tobacco and Other Drug Research Unit, South African. Medical Research Council, Pretoria, South Africa

Accepted October 14, 2015

 

Codeine, a weak opiate, requires increased pharmacovigilance relating to availability, heterogeneous nature of misuse, dependence and associated harm. A scoping review of literature on codeine was conducted using Arksey & O’Malley’s framework (1). Databases searched included PubMed, EBSCO Host, Science Direct, EMBASE, PsycINFO, Cochrane library and Medline from 1994 to 2014. Follow-up search strategies involved hand searching and searching of pharmaceutical, health, medical and drug related websites. Initial screening identified 3,105 articles with 475 meeting the inclusion criteria. Eight broad categories organised the literature, data charting and qualitative synthesis. This paper presents implications for practice and makes recommendations to address these issues. Themes identified relate to raising public and practitioner awareness, risk management, dispensing practices and monitoring and surveillance of codeine. Evidence to inform law enforcement, drug surveillance, public health initiatives, harm reduction approaches, pharmacy, clinical and treatment practices is warranted.

 

Keywords: codeine, over the counter, misuse, dependence, policy