The rate of codeine-related deaths in Australia more than doubled between 2000 and 2009, driven primarily by an increase in accidental overdoses, according to new research by the National Drug and Alcohol Research Centre.
Just under half of all codeine related deaths (48.8 per cent) were from accidental overdoses and one third from intentional self harm according to the study.
More than half (53.6%) of the cases of codeine-related death included a history of mental health problems, 36.1% a history of substance use problems (including misuse and dependence), 35.8% a history of chronic pain, 16.3% a history of injecting drug use, and 2.7% a history of cancer.
Those who had intentionally overdosed were more likely to be older, female and have a history of mental health problems; those who had accidentally overdosed were more likely to have a history of substance use problems, chronic pain and injecting drug use.
"There are documented risks associated with prolonged codeine use. It can produce tolerance, which may lead to escalating doses and dependence, particularly among patients whose pain is not well managed," said the report.
Risks are also associated with products that combine codeine with other analgesics. Prolonged use of high-dose codeine-ibuprofen combinations has been linked with gastrointestinal disease and renal failure, while paracetamol-codeine combinations have been linked with hepatotoxicity (liver problems).
Last week Fairfax Media reported that from June next year about 150 codeine products may no longer be available over the counter at pharmacies.
Medicines affected include Nurofen Plus, Panadeine, Codral Original Cold and Flu tablets, Aspalgin soluble tablets, Mersyndol tablets and some cough and cold medications that can be bought at chemists with no current restrictions.
