A new study investigates an emerging societal problem of “respectable addiction,” a condition that is often associated with codeine-based medicines purchased from pharmacies.
The UK study was undertaken by Dr. Richard Cooper, Lecturer in Public Health, School of Health and Related Research, University of Sheffield.
Cooper and his team sought to describe and understand current issues relating to over-the-counter (OTC) medicine addiction by investigating the experiences of individuals affected by medicine abuse.
Opinions were also garnered from pharmacists and medicines counter assistants (MCAs) and key stakeholders.
Addicted individuals in the qualitative study all described the use of an opiate — usually codeine. For most, the initial use of the medication was associated with a legitimate medical condition.
Types of abuse were identified based on quantity of medicine taken, ranging from never exceeding the maximum recommended dose, to taking significantly higher doses than recommended.
All subjects described withdrawal symptoms and using the medicine for different reasons than clinically indicated and all had attempted to stop.
Interestingly, addicted individuals turned to Internet support groups or a request for additional medical treatment with an objective of hiding their addiction.
None of the participants sought help from the pharmacists, as individuals blamed themselves more than pharmacists, regulation, manufacturers or doctors for their OTC medicine addiction.
Individuals were termed “respectable addicts” based on their own recognition of, and use of the word addiction, and their desire to present themselves as being normal and very different from their perception of illicit drug misusers.
Health professionals and policymakers identified codeine as a key problem, but supported the continued availability of OTC medicines to enable the public to manage their own symptoms, as long as risks were known.
However, concerns were raised in relation to the current lack of treatment and support options and the availability of medicines via the Internet as an increasing safety concern.
Key issues identified by Cooper’s team include:
- Protecting individuals from the potential harms of medicines while ensuring they remain accessible to the public;
- Recognizing that OTC medicines are often considered less harmful than prescription medicines but are still capable of causing addiction;
- Providing addiction services to a “hidden” and secretive group of individuals who perceive themselves to be respectable and professional and different from others.
He concludes: “Raising awareness of OTC medication addiction and improving treatment and support options are key to managing these and other issues discussed in the study.”
Source: Pharmacy Practice Research Trust