Analgesic misuse

Question 1

What are commonly misused analgesics

Answer 1

codeine and dihydrocodeine

Question 2

What are the rules and regulations surrounding codeine and dihydrocodeine (2)

Answer 2

1. Packaging of ‘For three days use only’ and ‘Can cause addiction’ (MHRA)
2. The maximum number of co-codamol tablets or capsules available OTC is restricted to32 (MHRA)

Question 3

Can you recommend Codeine and dihydrocodeine products for mild pain or pain associated with cold and flu (2)

Answer 3

1. The indication of codeine-containing OTC analgesics is restrictedonlyfor the treatment ofacute (short term) moderate painwhich has not responded to paracetamol, ibuprofen or aspirin.
2. This means these products should not be recommended for mild pain or pain associated with cold and flu

Question 4

What are important reminders for the sale of codeine and dihydrocodeine (4)

Answer 4

1. You have a responsibility to inform your pharmacist of any unusual requests of codeine or dihydrocodeine-containing products.
2. This includes when a customer makes a request for excessive quantities or when an individual requests to purchase such products on a frequent basis.
3. Requests for large quantities of codeine-containing analgesic products will require further questioning by the pharmacist, who may decide to refer the patient to their doctor.
4. Some patients may be buying and taking long-term analgesics which are masking another more serious disease that may need to be investigated

Question 5

What is the importance of signposting with OTC analgesic misuse (2)

Answer 5

1. It is important that you advise customers that these analgesics are for three days use only and not to use OTC analgesics on a long-term basis without consulting their doctor and warn them of the potential for dependence with such products
2. There are some charities, support groups and online forums that can provide help and advice to such individuals.