Tackling Codeine Dependance

South Africa’s Over-the-Counter Addiction

- Mandy Collins

From Sherlock Holmes to Dr. Gregory House, addiction to opioids is part and parcel of various forms of fiction. And these are not your traditional ‘junkies’ lying comatose on a street corner, strung out on illegal drugs. These are functional, intelligent human beings going about their daily business – just so long as they get their regular dose of opioids.

But this kind of addiction is not the sole preserve of fiction. There are many people walking around addicted to prescription medications, and one of the more common ones is codeine.

Used as indicated, codeine is an excellent painkiller and used a great deal in both over-the-counter applications, and via prescription after surgery. But it comes with concerns thanks to its addictive nature. In fact, a recent study out of Stanford University noted that patients who filled opioid prescriptions perioperatively (shortly before or after surgery), were about three times as likely to still be using opioids up to six months or even a year later, compared with those who did not.

Researchers examined data on 466 677 people who’d had plastic and reconstructive procedures for the nose, eye, breast, abdomen or soft tissue from 2007 to 2015. Almost 55% of patients received painkiller prescriptions afterward, and 92% of the prescriptions filled were for opioids.

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others.

Most are available only by prescription, but in South Africa, you can buy codeine over the counter – in preparations for pain, in cough syrups, and even in some pediatric medicines. And when use of these medicines turns into abuse, there’s a risk of addiction. So it pays to tread carefully.

Codeine as a pain treatment