• Matthew Y Frei, Suzanne Nielsen, Malcolm D H Dobbin, and Claire L Tobin.
• Turning Point Alcohol and Drug Centre, Eastern Health, Melbourne, VIC, Australia. matthew.frei@easternhealth.org.au
• Med. J. Aust. 2010 Sep 6; 193 (5): 294-6.

ObjectiveTo investigate morbidity related to misuse of over-the-counter (OTC) codeine-ibuprofen analgesics.Design And SettingProspective case series collected from Victorian hospital-based addiction medicine specialists between May 2005 and December 2008.Main Outcome MeasuresMorbidity associated with codeine-ibuprofen misuse.ResultsTwenty-seven patients with serious morbidity were included, mainly with gastrointestinal haemorrhage and opioid dependence. The patients were taking mean daily doses of 435-602 mg of codeine phosphate and 6800-9400 mg ibuprofen. Most patients had no previous history of substance use disorder. The main treatment was opioid substitution treatment with buprenorphine-naloxone or methadone.ConclusionsAlthough codeine can be considered a relatively weak opioid analgesic, it is nevertheless addictive, and the significant morbidity and specific patient characteristics associated with overuse of codeine-ibuprofen analgesics support further awareness, investigation and monitoring of OTC codeine-ibuprofen analgesic use.

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