title: Codeine use, dependence and help-seeking behaviour in the UK and Ireland: an online cross-sectional survey.
abstract: BACKGROUND
  Codeine misuse and dependence poses a clinical and public health challenge. However, little is known about dependence and treatment needs in the UK and Ireland.
  
  
  OBJECTIVE
  To characterize codeine use, dependence and help-seeking behaviour.
  
  
  METHODS
  An online cross-sectional survey advertised on Facebook, Twitter, health and drug websites and e-mail circulars.
  
  
  METHODS
  The survey collected data on demographics and codeine use amongst adults from the UK and Ireland. The Severity of Dependence Scale measured the level of codeine dependence.
  
  
  RESULTS
  The sample of 316 respondents had a mean age of 35.3 years (SD = 12.3) and 67% were women. Of the 316 respondents, 54 scored ≥5 on the Severity of Dependence Scale indicating codeine dependence (17.1%). Our study found that codeine dependence is a problem with both prescribed and 'over-the-counter' codeine. Codeine dependence was associated with daily use of codeine, faking or exaggerating symptoms to get a prescription for codeine and 'pharmacy shopping' ( P < 0.01). A higher number of respondents had sought advice on the Internet (12%) rather than from their general medical practitioner (GP) (5.4%). Less than 1% of respondents had sought advice from a pharmacist.
  
  
  CONCLUSIONS
  Codeine dependent users were more likely to seek help on the Internet to control their use of codeine than from a GP, which may indicate a potential for greater specialized addiction treatment demand through increased identification and referrals in primary care.
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, SE5 8BB, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Kimergård
authors.affiliation: School of Health Sciences, Waterford Institute of Technology, Main Campus Cork Road, X91 K0EK, Waterford, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Foley
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, SE5 8BB, London, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Davey
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, SE5 8BB, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dunne
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, SE5 8BB, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Drummond
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, SE5 8BB, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Deluca
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D003061:Codeine / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D000076064:Drug Misuse / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000592:standards / Q000706:statistics & numerical data; D000066505:Help-Seeking Behavior; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D004366:Nonprescription Drugs / Q000009:adverse effects / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D055553:Prescription Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D004366:Nonprescription Drugs; D055553:Prescription Drugs; D003061:Codeine