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Heroin Addiction and Related Clinical Problems: 2018, 20, N5 (pages: 13 - 17)

An evaluation of community pharmacist perception of the misuse and abuse of over-the-counter co-codamol in Cornwell and Devon, UK: a cross-sectional survey

Barrett R., and Costa D.

Summary: Background: Codeine containing preparations have the potential to cause harm and dependence. Recent UK regulatory changes to the pack-size and printed warnings have been instituted to reduce this potential. However, there is a reported increase in the misuse of codeine containing analgesics in countries where it is available over-the-counter. This is a challenge for pharmacies and pharmacists globally. Aim: To evaluate the perceptions of community pharmacists on the nature and management of Over-The-Counter (OTC) co-codamol (paracetamol and codeine combination preparations) misuse and abuse. Methods: A self-report, postal survey was developed and posted to 65 pharmacies in Cornwall and 85 pharmacies in Devon (n=150) in the UK. Qualitative and quantitative data was analysed using descriptive statistics, hypothesis testing and thematic analysis. Results: Most pharmacists perceived their patients and community as having some challenges with the misuse of co-codamol. Pharmacists think that co-codamol is not harmful if used as indicated. The behaviours pharmacist associated with misuse were frequent to purchase and misinformation provided by the patient during consultation. Counselling and referral are the main interventions utilised by pharmacist in such circumstances. Pharmacists who have received training on co-codamol abuse know where to refer customers. Conclusions: Community pharmacists face a difficult challenge when suspecting misuse. However, pharmacists believe co-codamol abuse can be reduced by increasing the public's awareness of the addictive potential of co-codamol.