Codeine misuse and dependence in South Africa – learning from substance abuse treatment admissions

S Dada, N Harker Burnhams, M C van Hout, C D H Parry


Background. Misuse of prescription and over-the-counter codeine-containing products is a global public health issue.

Objectives. To investigate the extent of treatment demand related to the misuse of codeine or codeine dependence in South Africa (SA) and the profile of patients seeking treatment, so as to understand the nature and extent of the problem.

Method. Data were collected from centres participating in the South African Community Epidemiology Network on Drug Use in 2014. A total of 17 260 admissions were recorded.

Results. There were 435 recorded treatment admissions for codeine misuse or dependence as a primary or secondary substance of abuse (2.5% of all admissions). Of treatment admissions, 137 (0.8%) involved codeine as the primary substance of abuse; 74.9% of patients were males, with an even spread across population groups. Ages ranged from 11 to 70 years, with the highest proportion aged 20 - 29 years; >40% were referred by self, family and/or friends, and 26.7% by health professionals; and 36.8% had received treatment previously. The majority reported misuse of tablets/capsules, with 17.6% reporting misuse of syrups. Oral use comprised 96.6% and daily use 63.1%.

Conclusions. Data from treatment admissions related to codeine misuse and dependence are informative, but provide an incomplete picture of the nature and extent of codeine-related problems in SA. Other data sources must be considered before further regulatory/policy changes regarding codeine are implemented. 

Authors' affiliations

S Dada, Haematopathology Department, National Health Laboratory Service, Chris Hani Baragwanath Hospital, Johannesburg, South Africa

N Harker Burnhams, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

M C van Hout, School of Health Sciences, Waterford Institute of Technology, Ireland

C D H Parry, Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

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Codeine; Misuse; Abuse; Dependence; Admissions; South Africa

Cite this article

South African Medical Journal 2015;105(9):776-779. DOI:10.7196/SAMJnew.8172

Article History

Date submitted: 2015-09-14
Date published: 2015-09-14

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