Codeine overdoses down 33% since 2010 painkiller restrictions

Drop could be used to support even stricter curbs on such products, study authors argue

Solpadeine is one of the codeine-containing products affected by the restrictions. Photograph: iStock

Solpadeine is one of the codeine-containing products affected by the restrictions. Photograph: iStock

 

Overdoses caused by strong over-the-counter painkillers dropped by a third following the introduction of restrictions on their sale a decade ago.

In 2010, restrictions were put on the sale of painkillers containing codeine, such as Nurofen Plus and Solpadeine, amid fears about the dangers of overdose and addiction.

Pharmacists were required to oversee all sales, and no more than three days’ worth of medication could be sold to any one customer. Pharmacists were also required to question customers about their need for the drug and if they had tried any less potent painkillers.

The Pharmaceutical Society of Ireland enforced the new rules through inspections.

The restrictions appear to have significantly reduced codeine overdoses, a newly published study funded by the Health Research Board suggests.

This reduction could also be used to support even stricter restrictions on codeine products, the authors suggests.

In 2005 the numbers of codeine overdoses from over-the-counter products reported to the National Poisons Information Centre stood at 200. By 2016 this had dropped to 75, a decrease of 62.5 per cent, according to the study, which was published in the journal Pharmacoepidemiol Drug Safety.

Addiction treatment

Although the number of overdoses had been declining steadily since 2005, by far the biggest decline – 33 per cent – occurred in 2010, when the new rules were introduced.

The researchers also noted there was no increase in prescriptions for other codeine products, suggesting customers were not attempting to replace over-the-counter painkillers with prescription products as a result of the restrictions.

The study also suggests increased questioning of customers by pharmacists on the reason for their codeine requirement may have caused more people to seek out addiction treatment.

“Pharmacist intervention is well described as a trigger for those misusing codeine to seek medical support.”

There were 1,851 codeine overdoses reported to the National Poisons Information Centre between 2005 and 2016. The average age of those who overdosed was 23, and 63 per cent were female, the study found. It is not known how many, if any, of these were fatal.

Almost two-thirds of cases involved over-the-counter painkillers. Fifty-five per cent involved “intentional poisonings”, with accidental overdoses accounting for 27 per cent and “therapeutic error” causing 15 per cent.