St Vincent's Hospital, FairviewSubstance Abuse Service

Over The Counter Drugs

Medications supplied without the need for prescription can be misused. People often wrongly believe that because they are available without prescription, these medications are “harmless”, “not strong” and can be used in amounts over and above what might be recommended.

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Codeine Based Products

These medications can be effective for the short-term relief of pain or cough, but can cause problems if too many are used too often.

OTC drugs in this group contain in combination, varying amounts of
Codeine and an additional analgesic (pain killer). Depending on the product, they can also contain caffeine, an anti-histamine and / or anti cholinergic elements
Using too much of these, whether individually or as a combination product can be high risk.

Codeine is a narcotic analgesic and is in the same drug group as heroin (opiates)
As and from the 1st of August 2010, a pharmacist must discuss with the customer, the suitability or other wise of using a codeine-based product.
See  for full details of the guidelines.

 

Effects

You can get up to date information on medicines from your doctor, pharmacist or visit www.medicines.ie Type in the name of your medicine in the ‘search for’ box at the top of the page. This will give you access to the Patient Information Leaflet (PIL) and the Summary of Product Characteristics (SPC) documents.

10 Common Signs of Misuse (in no particular order):

          1.  The initial reason you started using the tablets for is gone e.g pain or cough, but you
                continue to use them for different reasons
          2.   You take more of the product, or swap between similar products, more often than you
                 used to
          3.   You make sure you always have a supply on hand
          4.   You buy your supplies from a range of different chemists
          5.   If a chemist asks you questions, you don’t return to buy there again
          6.   You find it difficult not to use them – you may make promises to yourself that you’ll use
                 less or stop using altogether, but it never seems to work out for long
          7.   Other people comment on your usage e.g. “are you taking that again?”
          8.   You start to hide your usage from family and friends
          9.   You may experience more aches, pains and headaches than you used to
          10. You believe you need to take them to cope with everyday things

 

What to Do?

  • Consider the pros and cons of your use, this can help in making a decision
  • Keep a diary of how much /how often you use over a period of two weeks
  • Also record the reason why you are taking them
  • Discuss your usage with your doctor.
  • If you have been using for a while, your doctor might suggest you have a range of blood tests, to check out your general health
  • Plan to reduce your usage gradually and continue to keep your record. Your doctor will be able to advise you on reductions.
  • If you have been using large amounts regularly, it can be risky to stop using suddenly
  • Look at alternative /drug free ways to manage your symptoms
    e.g.  Stress management and relaxation techniques
             Exercise and diet
             Talking to someone about how you feel
             Check out support organisations
             e.g. www.migraine.ie
                     www.chronicpain.ie
                     www.aware.ie
                     www.mentalhealthireland.ie

Your doctor may suggest referral to a specialist counselling service for help and support.