• S Dada, N Harker Burnhams, M C Van Hout, and ParryC D HCD.
• Haematopathology Department, National Health Laboratory Service, Chris Hani Baragwanath Hospital, Johannesburg, South Africa. gertrude@hmpg.co.za.
• S. Afr. Med. J. 2015 Sep 14; 105 (9): 776-9.

BackgroundMisuse of prescription and over-the-counter codeine-containing products is a global public health issue.ObjectivesTo 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.MethodData 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.ResultsThere 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%.ConclusionsData 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.

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