Abstract
BackgroundMisuse of codeine available on prescription and over-the-counter (OTC) has been highlighted as a potential problem in South Africa.ObjectiveTo examine the perceptions of medical professionals regarding codeine use (prescribed and OTC), misuse, dependence and treatment options in South Africa.MethodData for the study were obtained using a sample of medical professionals obtained through random and convenience sampling. A quantitative methodology was employed using a structured self-administered questionnaire with closed and open-ended items. Data analysis was conducted using SPSS version 21; 238 medical professionals involved in the prescribing of codeine completed the questionnaire.ResultsTwo-thirds of participants stated that they routinely reviewed patients prescribed codeine, and high levels of concern were expressed about the availability of OTC medicine containing codeine in pharmacies (84.9%) and on the internet (71.3%). There was agreement that medicines containing codeine should be regulated to a prescription-only medicine (85.3%). Only 22% of participants agreed that they had suitable screening methods to help with detection of codeine dependence. Eighty per cent indicated that they would welcome the opportunity for greater instruction on prescribing potentially addictive medicines.ConclusionThere appears to be a need to improve education on consumption and risks associated with codeine use. In addition, screening tools are needed to detect those with codeine dependence. Greater data sources are now needed to examine the sale of and consumption of codeine medicines in the interest of public health.
Highlights
Opioids are widely used in the management of pain-related conditions in primary health care
Misuse of codeine medicines has been highlighted as a potential problem in South Africa.[2,3]
The findings indicate that medical prescribers do ask patients about prescribed and OTC codeine use
Summary
Opioids are widely used in the management of pain-related conditions in primary health care. A weak opioid, is commonly prescribed for the acute onset of pain, as a treatment for cough and to a lesser extent for diarrhoea.[1] In recent times, misuse of codeine medicines has been highlighted as a potential problem in South Africa.[2,3] Misuse of codeine is defined as using medication obtained with or without a medical prescription outside of accepted medical guidance. This may include dosage regimes that are higher or used for longer periods than medically advised, for the purpose of intoxication, including recreational use, or where the risks outweigh the benefits.[4] Dependence is classified as a psychiatric disorder under the DSMIV diagnostic criteria.[5]. Misuse of codeine available on prescription and over-the-counter (OTC) has been highlighted as a potential problem in South Africa
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Schedule a callMore From: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa
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