A cross-sectional analysis of over-the-counter codeine use among an Australian sample of people who regularly inject drugs

Arora, S; Roxburgh, A; Bruno, R; Nielsen, S; Burns, L

A cross-sectional analysis of over-the-counter codeine use among an Australian sample of people who regularly inject drugs

Arora, S

Roxburgh, A Bruno, R Nielsen, S Burns, L

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Publication Type:: Journal Article
Citation:: Drug and Alcohol Review, 2013, 32 (6), pp. 574 - 581
Issue Date:: 2013-11-01

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Field	Value	Language
dc.contributor.author	Arora, S https://orcid.org/0000-0002-7562-2416	en_US
dc.contributor.author	Roxburgh, A	en_US
dc.contributor.author	Bruno, R	en_US
dc.contributor.author	Nielsen, S	en_US
dc.contributor.author	Burns, L	en_US
dc.date.available	2013-05-19	en_US
dc.date.issued	2013-11-01	en_US
dc.identifier.citation	Drug and Alcohol Review, 2013, 32 (6), pp. 574 - 581	en_US
dc.identifier.issn	0959-5236	en_US
dc.identifier.uri	http://hdl.handle.net/10453/27709
dc.description.abstract	Introduction and Aims: The study aims to examine the medical and non-medical use of over-the-counter (OTC) codeine combination drugs in a sample of people who inject drugs; and to examine risk factors associated with exceeding the recommended dose of OTC codeine, including the experience of pain. Design and Methods: This study analysed annual survey data from a convenience sample of people who inject drugs in Australia who are interviewed for the Illicit Drug Reporting System. People who have injected drugs (n=902) on at least a monthly basis in the preceding six months across Australia were interviewed. Participants were asked about their use of OTC codeine and their experience of pain. Results: One third (35%) of participants had used OTC codeine in the preceding six months and 52% (95% confidence interval 48.7-55.3) of this group had exceeded the recommended dose on their last occasion of use. This clearly places them at increased risk of harms associated with toxicity from the accompanying analgesic found in combination codeine products. Multivariate analyses demonstrated that those exceeding the recommended codeine dose of OTC codeine were more likely to be experiencing moderate to very severe pain. Discussion and Conclusion: There is a need to evaluate the approach to pain management in this population. Greater pharmacist involvement, real-time monitoring of sales, the development of screening tools to identify those at risk of harm and further education of primary care practitioners could be beneficial in reducing the risk of harm associated with these medications for all users of OTC codeine, including people who inject drugs. © 2013 Australasian Professional Society on Alcohol and other Drugs.	en_US
dc.relation.ispartof	Drug and Alcohol Review	en_US
dc.relation.isbasedon	10.1111/dar.12059	en_US
dc.subject.classification	Substance Abuse	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Pain	en_US
dc.subject.mesh	Substance Abuse, Intravenous	en_US
dc.subject.mesh	Codeine	en_US
dc.subject.mesh	Analgesics, Opioid	en_US
dc.subject.mesh	Drug Combinations	en_US
dc.subject.mesh	Data Collection	en_US
dc.subject.mesh	Severity of Illness Index	en_US
dc.subject.mesh	Multivariate Analysis	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Professional Role	en_US
dc.subject.mesh	Dose-Response Relationship, Drug	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Pharmacists	en_US
dc.subject.mesh	Pharmaceutical Services	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Nonprescription Drugs	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	A cross-sectional analysis of over-the-counter codeine use among an Australian sample of people who regularly inject drugs	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	32	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
utslib.for	1403 Econometrics	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	16 Studies in Human Society	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	32	en_US

Abstract:

Introduction and Aims: The study aims to examine the medical and non-medical use of over-the-counter (OTC) codeine combination drugs in a sample of people who inject drugs; and to examine risk factors associated with exceeding the recommended dose of OTC codeine, including the experience of pain. Design and Methods: This study analysed annual survey data from a convenience sample of people who inject drugs in Australia who are interviewed for the Illicit Drug Reporting System. People who have injected drugs (n=902) on at least a monthly basis in the preceding six months across Australia were interviewed. Participants were asked about their use of OTC codeine and their experience of pain. Results: One third (35%) of participants had used OTC codeine in the preceding six months and 52% (95% confidence interval 48.7-55.3) of this group had exceeded the recommended dose on their last occasion of use. This clearly places them at increased risk of harms associated with toxicity from the accompanying analgesic found in combination codeine products. Multivariate analyses demonstrated that those exceeding the recommended codeine dose of OTC codeine were more likely to be experiencing moderate to very severe pain. Discussion and Conclusion: There is a need to evaluate the approach to pain management in this population. Greater pharmacist involvement, real-time monitoring of sales, the development of screening tools to identify those at risk of harm and further education of primary care practitioners could be beneficial in reducing the risk of harm associated with these medications for all users of OTC codeine, including people who inject drugs. © 2013 Australasian Professional Society on Alcohol and other Drugs.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/27709