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Practice implications and recommendations for managing codeine misuse and dependence.

Michael Bergin, Ian Norman, Michelle Foley

    Acta Pharmaceutica (Zagreb, Croatia)
    |December 19, 2015
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    Codeine, a weak opiate, requires enhanced pharmacovigilance due to misuse and harm. This review highlights the need for better public awareness, risk management, and monitoring of codeine use.

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    Area of Science:

    • Pharmacology
    • Public Health
    • Drug Safety

    Background:

    • Codeine, a weak opiate, presents significant pharmacovigilance challenges.
    • Issues include availability, misuse patterns, dependence, and associated harms.

    Purpose of the Study:

    • To conduct a comprehensive scoping review of literature on codeine.
    • To identify implications for practice and formulate recommendations.

    Main Methods:

    • Scoping review utilizing Arksey & O'Malley's framework.
    • Searched multiple databases (PubMed, EMBASE, PsycINFO, etc.) from 1994-2014.
    • Included hand searching and website searches; 475 articles met inclusion criteria.

    Main Results:

    • Literature organized into eight broad categories.
    • Identified themes: public/practitioner awareness, risk management, dispensing practices, and monitoring/surveillance.
    • Highlighted need for evidence in law enforcement, public health, harm reduction, and clinical practices.

    Conclusions:

    • Urgent need for increased pharmacovigilance regarding codeine.
    • Recommendations focus on awareness, risk management, dispensing, and surveillance.
    • Further evidence is required to inform various sectors on codeine safety and management.