Over-the-counter painkillers that contain codeine are ‘tip-toeing’ more people into addiction, according to one researcher.
Emma McDonnell, a medical student at the University of Limerick, says: “Codeine addiction is an epidemic verging on eruption.”
McDonnell, who is studying in the graduate-entry medical school at UL, previously qualified as a pharmacist at Trinity College Dublin. She does weekend locum work in pharmacies to help pay her college fees.
While problems with cocaine are often in the headlines, over-the-counter codeine pain killers are an emerging addiction scourge, she says.
“The research I have done, and articles I have had published, have been drawn from my working life as a pharmacist, to date,” says Ms McDonnell. “In pharmacy college, we were taught about addiction pharmacy and we were very much aware of our duty, as pharmacists, to inform people when dispensing products.
Codeine products, obviously, were something we had to deal with warning people about the side-effects, sedation, and also the addictive properties it had and not to use a codeine product for more than three days.
"And then, when I went out to work as a pharmacist and saw the amount of codeine products which are sold on a daily basis, it made me very aware of the issues surrounding codeine. Over-the-counter, it is in various products used for pain.”
Ms McDonnell says codeine addiction is a major worry. Codeine is an opioid medication used to control or relieve pain. It is found in many pain medications, including over-the-counter products, such as Nurofen Plus and Solpadeine.
Ms McDonnell, who is 27 and from Dublin, says: “Everything I say is observational on my experiences to date, on what I have seen with the amount of codeine sold and the regularity with which it is sold. And from speaking to pharmacist colleagues and friends, regularly, the issue of codeine use would come up.”
McDonnell wants to draw attention to the overuse of codeine.
“People can get a high on codeine and withdrawal symptoms can progress quite quickly, so this can lead to other symptoms, such as shaking, sweating, and difficulty sleeping. If the problem grows, the addiction and tolerance can grow quickly,” she says.
Because codeine is available without prescription, people regard it as something that is not too drastic and that is why I have written papers on it — not to scare-monger, but to open people’s eyes to the potential dangers of codeine.
"The opiate side of codeine can give some people ‘a buzz’. And I want to increase awareness about codeine being an opiate and the fact that it has addictive qualities.
“The big US stories we read about relate to prescription opioids. But people who take codeine can see it as different from these high-profile opiates. A lot of people who take codeine don’t know it is an opioid and don’t see it as addictive and have a notion that just because it is available over the counter, it is not addictive. But because something does not require a prescription does not mean it is not a serious drug.”
However, McDonnell says making codeine products prescription-only would put more pressure on GPs and says that making people aware of the addictive potential of codeine is crucial, as is “making people aware of other non-codeine painkillers, that are available in tackling a pain”.