Best practices and innovations for managing codeine misuse and dependence
Date
2016-10-27
Journal Title
Journal ISSN
Volume Title
Publisher
Canadian Society for Pharmaceutical Sciences
Abstract
Purpose: Promoting and ensuring safe use of codeine containing medicines remains a public
health issue given the rise in reporting of misuse and dependence particularly in countries where available over–the-counter (OTC). The aim of this unique study was to identify best practices in management of opioid abuse and dependence, particularly codeine, and innovations to meet challenges surrounding safe and compliant use, patient awareness-raising, reducing health harms and enhancing successful treatment of dependence.
Methods: A mixed methods approach using three data points was used that included : (1) analysis of data from
existing scoping reviews to identify potential areas for innovation (2) interviews with key national stakeholders
from public health, pharmaceutical, regulatory, primary care and addiction practice in three distinct regulatory
regimes (Ireland, United Kingdom and South Africa); and (3) a circular email request for information on
potential innovations to members of the European Medicine’s Agency European Network of Centres for
Pharmacoepidemiology and Pharmacovigilance (ENCEPP). Data from these three sources were analysed to
identify best practices and opportunities for innovation. Results. Best practices and potential innovations were
identified under the nine headings: (1) manufacture; (2) product information and public education; (3)
responsible prescribing; (4) monitoring and surveillance; (5) dispensing, screening and brief interventions in
community pharmacies; (6) safety in the workplace and on the road; (7) internet supply of codeine and online
support; (8) treatment of codeine dependence; and (9) learning resources and training for health professionals.
Conclusions: Challenges ensuring availability of codeine containing medicines for legitimate therapeutic use,
while minimising misuse, dependence and related health harms warrant consideration of new innovations. Most
promising innovative potential lies across the products’ retail lifecycle from manufacture to prescriber and
community pharmacy practitioner.
Description
CITATION: Norman, I. J., Bergin, M., Parry, C. D. & Van Hout, M.-C. 2016. Best practices and innovations for managing codeine misuse and dependence. Journal of Pharmacy and Pharmaceutical Sciences, 19: (3):367-381, doi:10.18433/J3T89K.
The original publication is available at https://journals.library.ualberta.ca/jpps
The original publication is available at https://journals.library.ualberta.ca/jpps
Keywords
Codeine, Pharmacology, Substance abuse, Pain -- Treatment, Analgesics
Citation
Norman, I. J., Bergin, M., Parry, C. D. & Van Hout, M.-C. 2016. Best practices and innovations for managing codeine misuse and dependence. Journal of Pharmacy and Pharmaceutical Sciences, 19: (3):367-381, doi:10.18433/J3T89K.