Can you describe the patient behaviours that trigger your suspicion of codeine misuse? |
Requesting prescriptions for codeine | 212 (71) |
Aberrant behaviour | 89 (30) |
Unresolved pain/cough | 78 (19) |
Lost prescriptions or medications | 52 (17) |
Physical or psychological symptoms | 41 (14) |
History of addiction | 38 (13) |
Doctor/pharmacy shopping for codeine medicines | 28 (9) |
History of comorbidity | 14 (5) |
Socioeconomic status | 14 (5) |
Sex | 3 (1) |
Can you describe the types of treatments that you use for patients with codeine dependence? |
Slow or gradual withdrawal | 153 (51) |
Education/counselling | 87 (29) |
Referral to secondary or specialist care | 87 (29) |
Restricted prescriptions | 60 (20) |
Substitution with another drug (drug not specified) | 30 (10) |
Substitution using methadone/buprenorphine/other opiate drug | 27 (9) |
Substitution with non-opioid medication | 15 (5) |
Substitution using benzodiazepines/other antipsychotics/other | 15 (5) |
Cold turkey | 9 (3) |
What were the main reasons for referring patients to specialist treatment?ii |
Failure to manage patient effectively in practice | 150 (50) |
Complex case requiring specialist care | 186 (62) |
Patient request for referral | 63 (21) |
Lack of resources | 45 (15) |