Codeine-related deaths double in 10 years
Research has found that the number of codeine-related deaths has doubled between 2000 and 2009.
Ms Amanda Roxburgh and colleagues from the National Drug and Alcohol Research Centre at the University of New South Wales used National Coronial Information System data and found that codeine-related deaths increased from 3.5 to 8.7 per million population.
Their results were published in the Medical Journal of Australia.
“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”, the researchers wrote.
Just under half (48.8%) were attributed to accidental overdose, and a third (34.7%) to intentional self-harm. Accidental overdoses increased significantly, with a 9.3% rise each year.
Codeine is the most consumed opioid Australia and is also the most accessible, available without a prescription however the TGA announced on Thursday that they would be reviewing this, with the opportunity for submissions until 15 October 2015.
The researchers said most codeine-related deaths (83.7%) were attributed to multiple drug toxicity.
“A small proportion (7.8%) were specifically attributed to codeine toxicity,” they wrote.
“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”, the researchers found.
The pattern suggested that in accidental death, there may be evidence of:
- codeine being used to top up prescribed pain medication;
- dose escalation of codeine; and
- the development of codeine dependence.
The researchers believe that there needs to be different public health and clinical strategies to prevent codeine overdoses.
“It is clearly necessary to increase the capacity to identify high-risk patients in primary care and to respond more effectively to their needs. Increasing the capacity of specialist pain, addiction and mental health treatment services in Australia should also be a priority,” they wrote.
Read the full article in the Medical Journal of Australia.