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Experiences of over‐the‐counter codeine misusers and accounts of recovery: A qualitative study in Tasmania, Australia
Author(s) -
Kirschbaum Melissa,
Barnett Tony,
Cross Merylin
Publication year - 2020
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1111/dar.13081
Subject(s) - codeine , over the counter , mental health , thematic analysis , qualitative research , psychology , psychiatry , medicine , nursing , medical prescription , sociology , pharmacology , social science , morphine
and Aims There is international concern about misuse of over‐the‐counter (OTC) codeine, yet few studies have reported the perspectives of misusers themselves. This study explored the experience of OTC codeine misuse and recovery in Tasmania, Australia. Design and Methods Semi‐structured telephone interviews were conducted with 15 self‐identified long‐term users of OTC codeine. The interview guide prompted responses about reasons for codeine use, positive and negative impacts, recovery, identity and codeine accessibility. Transcripts were analysed abductively using qualitative content analysis. Categories that emerged from misuser accounts were aligned to three broad temporal phases: (i) transition to misuse; (ii) growing awareness; and (iii) towards recovery. Results Salient features of the misuse experience included: initial use for the self‐treatment of physical pain; ongoing use to self‐medicate physical pain, stress or mental health conditions; a perception of safety of OTC codeine; an insidious transition from use to misuse; growing awareness of a problem over time; support provided by family, friends and the internet; recovery through self‐change; and recognition that recovery is an ongoing process. Discussion and Conclusions Knowledge and understanding of the experience of OTC codeine misuse and recovery is critical to inform and tailor approaches to prevention and intervention. The findings suggest that strategies to improve the management of pain, stress and mental health, raise self‐awareness of problematic use and potential for self‐change, and increase social and web‐based supports, should be considered when designing health policy initiatives that aim to reduce misuse.