Although codeine-ibuprofen can be considered a relatively weak opioid analgesic, it is nevertheless addictive and more research is needed to develop health care responses to its misuse, according to an article in the Medical Journal of Australia.

Dr Matthew Frei, Clinical Head at Southern and Eastern Health Alcohol and Drug Services and Adjunct Senior Lecturer at the School of Psychology and Psychiatry, Monash University, Melbourne, and co-authors investigated morbidity related to the misuse of over-the-counter (OTC) codeine-ibuprofen analgesics between May 2005 and December 2008.

Twenty seven patients with serious morbidity were studied. On average, the patients were taking daily doses of 435-602mg of codeine phosphate and 6800-9400mg ibuprofen.

Dr Frei said that the patients suffered from gastrointestinal disease, renal failure and anaemia and that most patients had no previous history of substance-use disorder.

“In many of these cases, serious morbidity resulted from use initiated for therapeutic reasons, such as easing persisting pain,” Dr Frei said.

“Given that these drugs are likely to remain available without prescription in Australia, physicians should ask specifically about non-prescribed analgesics when taking a medication history.

“Pharmacy personnel should consider the risk of misuse when supplying these combination analgesic products.

“The significant morbidity and specific patient characteristics associated with overuse of codeine-ibuprofen analgesics support further awareness, investigation and monitoring of OTC codeine-ibuprofen analgesic use.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACT:            Dr Matthew Frei                            03 9843 1288 / 0408 362 110