Ireland is on the verge of a codeine addiction epidemic, with patients “codeine shopping” between pharmacies making it difficult to monitor usage.
A paper in Irish Medical Journal (IMJ) March edition warns that it can be tricky for pharmacists to spot unsuitable codeine sales when patients give “well constructed and credible explanations regarding pain” and when there are “no obvious signs of misuse”.
The paper’s author, Emma O’Donnell, a medical student at University of Limerick and a practising community pharmacist, says without medical supervision, a large proportion of the population is self-medicating with codeine [an opiate] "and many have unknowingly developed an addiction”.
Ms O’Donnell’s says codeine is an addiction “often hidden under the guise of pain management” that goes “unaddressed by both doctor and patient”.
As well as providing pain relief, it elicits effects “such as euphoria and sedation which give the user short-term experience of a ‘buzz’ or ‘calm’,” Ms O’Donnell says.
Under Irish law, it can be bought over-the-counter under supervision of a pharmacist, but Ms O’Donnell points out: “It may be difficult to monitor a particular patient if they are ‘codeine shopping’ - travelling to different pharmacies to purchase codeine."
Ms O’Donnell says a psychological and physiological dependence can develop "after a matter of days and drug tolerance increases quickly correspondingly". She says: “It is important to note that those suffering from codeine addiction may have a self-perception that they are distinct from those with illicit drug addictions."
Ms O’Donnell says one way of tackling the problem may be to make codeine prescription-only. She concludes in her paper - Codeine usage in Ireland: A timely discussion on an imminent epidemic - that “Codeine addiction is an epidemic verging on eruption and should be recognised now”.