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Advice on Codeine Supply Helping to Reduce Overdoses

June 08, 2021

The PSI has welcomed new research¹ from University College Cork and the National Suicide Research Foundation which indicates that the pharmacy regulator’s guidance² for pharmacists on the safe supply of codeine is linked with a significant reduction in intentional drug overdoses involving the drug. Commenting on the study, which was published recently in the European Journal of Public Health, Niall Byrne, PSI Registrar, said “the study demonstrates that the high levels of engagement with the guidance by pharmacists was an important factor in lowering the incidence of harm.”

The research shows that the number of people presenting to hospitals with codeine related intentional drug overdoses (IDOs) fell by 20% from October 2010 to December 2013 compared to January 2007 to March 2010. The reductions were more evident in IDOs involving women and while incident levels fell across all age-groups, they were most pronounced amongst those aged under 25. The co-authors note that their findings “support previous research that also concluded that young to middle-aged people tend to be most likely to harm using IDO.”

Niall Byrne stated: “The PSI’s principal function is to ensure patient safety and public protection. The PSI guidance on the supply of non-prescription products containing codeine arose from a clear and evident need to reduce the very real risk of harm arising from the misuse of these products and their potential contribution to intentional drug overdoses. We welcome the conclusions on the effectiveness of our guidance, and we remind all pharmacists of the importance of continuing to comply with this guidance and, thereby, protect their patients.”

Introduced in May 2010, the PSI guidance obliges pharmacists to advise patients on the correct use of products containing codeine, while also ensuring that patients understand that these drugs are for short-term use only. The guidance also covers the display of products, requiring that they are stored in an area under the direct control of the pharmacist and out of the view of the public. Adherence with the guidance is among the areas verified during routine pharmacy inspections by the PSI.

Full details of the PSI’s guidance on the safe supply of codeine-containing products is available on this website.

¹ “The impact of guidance on the supply of codeine-containing products on their use in intentional drug overdose”. Emma Birchall, Ivan J. Perry, Paul Corcoran, Caroline Daly, Eve Griffin European Journal of Public Health

² Non-prescription Products Containing Codeine – Guidance for Pharmacists on the Safe Supply to Patients

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