Advice to pharmacists on the dispensing of products containing codeine has had a significant impact in reducing intentional drug overdoses in which those drugs were a factor.
Teams from University College Cork and the National Suicide Research Foundation have co-authored new research based on presentations for intentional drug overdose (IDO) to Irish hospitals between the start of January 2007 and the end of December 2013, as recorded by the National Self-Harm Registry Ireland.
In that period a total of 57,759 intentional drug overdoses were recorded, with 4,789 (8.3%) involving a codeine-containing product.
However, the rate of codeine-related incidents was 20% lower in the period following the implementation of new guidance.
While codeine has been listed as a controlled drug in The Misuse of Drugs Act in Ireland since 1977, it was in 2010 that the Pharmaceutical Society of Ireland (PSI), in conjunction with the Irish Medical Council, issued guidance for pharmacists which outlined how to follow the previous legislation in relation to the supply of codeine-containing products.
That guidance included advising the storage of codeine-containing products outside of public view, the provision of only short-term prescriptions, the need to advise patients of the correct usage and risks associated with codeine and the requirement that ‘combination’ products are only dispensed as ‘second-line treatment’.
The authors of The impact of guidance on the supply of codeine-containing products on their use in intentional drug overdose, found that after the guidance was introduced, reductions were observed across all ages and were more pronounced for females than males, while the rate of intentional drug overdoses involving other drugs decreased by 3% in the same period.
According to the research, published in the: "Our findings indicate that the rate of codeine-related IDOs was significantly lower in the period following the implementation of the guidance.
"There is a large body of evidence supporting the restriction of potentially harmful medication as an effective strategy in suicide prevention.
"Our findings are consistent with another Irish study, which reported a 33% reduction in the number of reported codeine poisonings to a national poisoning centre in the year following the introduction of the guidance," it said.
The authors said the study showed that universal suicide prevention measures can have positive impacts on those at risk of self-harm and suicide and demonstrates the important role that restriction measures have in national and international suicide prevention strategies and policy.
* If you have been affected by any of the above issues, you can contact Samaritans on their website, samaritans.ie, or call 116 123.