An increasing number of people in Ireland are becoming addicted to codeine and one of the main reasons for this is the easy availability of the drug, it has been claimed.

Codeine is a relatively mild analgesic (painkiller), however its potency should not be underestimated, according to Gerry Ryan, project manager of the Tolka River Project, an addiction rehabilitation centre in Dublin.

"While far from being as strong as morphine or its derivatives, codeine is metabolised in the body in the same way as morphine so it has a similar but milder opiate effect," he explained.

Many over-the-counter (OTC) products contain codeine, such as Solpadeine and Nurofen Plus, as well as prescription-only products such as Tylex and Solpadol.

"Codeine is easily accessible. In Ireland, it can be obtained without a prescription, with most people being unaware of the potential for addiction when starting to use it," Mr Ryan noted.

He said that the transition from use to misuse ‘occurs at the point when people begin to neglect the directives set out with their doctor or pharmacist'.

Mr Ryan pointed out that guidelines were introduced to regulate how OTC codeine products are sold in pharmacies a few years ago. Now, a person must speak to their pharmacist about why they need these products.

However, he also emphasised that those who develop problems with codeine ‘are often not the type we would consider typical drug misusers'.

"They hold down good jobs, many in professions including healthcare, the legal world, the IT sector, teachers etc... They can have very good family relationships and appear to be very ‘normal'.

"Many people have cited their codeine use developed from dealing with stress and the physiological effects on stress of the body. This can make identifying and intervening in codeine misuse/addiction difficult," Mr Ryan said.

He insisted that the easy availability of codeine is the main cause of misuse of the drug and people's early introduction to it can range from trying to manage the symptoms of a hangover to managing minor aches and pains.

Mr Ryan noted that for the most part, people use codeine properly, however, addiction to it ‘is increasing, with many treatment services recording an increase in OTC codeine use and dependence'.

He explained that tolerance to codeine builds quickly, so people need to take more to get the same effect. As they become addicted, health issues may become apparent, such as liver problems, sleep problems and effects in heart rhythm.

Symptoms of withdrawal can include mood swings, insomnia, depression, nausea, a runny nose, watery eyes, diarrhoea and loss of appetite.

However, addiction to codeine can be treated. Physical withdrawal can take up to a week and GPs can help with this. Ongoing rehabilitation is advisable, such as counselling.

"Codeine has fast become a daily support for those living busy lives with high stress levels and also to those in isolation of some kind. What we do know is that most misusers, if not all, initially use these medications for relief from pain of some kind, but it fills a void and becomes a ‘friend'.

"However, recovery is possible. The most important thing is to seek help," Mr Ryan added.

He made his comments in the journal, WIN (World of Irish Nursing and Midwifery). For more information on the Tolka River Project, click here