Doctors say too many Brits addicted to OTC drugs

May 7 2007

Doctors in Britain are warning about the dangers of becoming addicted to over-the-counter (OTC) medicines; they say more research is needed on how many misuse OTC drugs.

The doctors say patients are reporting substance abuse problems with OTC drugs containing codeine phosphate and more addiction warnings should be provided to the public.

Dr. Chris Ford and Dr. Beth Good say they have seen three patients addicted to drugs containing codeine in recent months, such as Nurofen plus (ibuprofen and codeine phosphate).

All three had started using the product for its approved indications, but their use had escalated as they became tolerant to the codeine element; all had gastrointestinal bleeding related to ibuprofen.

Dr. Ford a general practitioner at Lonsdale Medical Centre, in London says Nurofen Plus, is a combination of codeine phosphate which is an opiate and ibuprofen and one patient was taking 30 tablets a day - the recommended maximum dose is six.

Codeine phosphate is only available on prescription but has been available OTC in low doses and in combination with aspirin, paracetamol, or ibuprofen for many years.

The doctors say that the most common addiction is to the OTC drug Solpadeine - a combination of paracetamol and codeine and sites on the internet suggests more than 4,000 people currently have this problem.

Dr. Ford does not think the drugs are unsafe, or that they should be banned but believes GP's are not picking up the problem.

Dr. Ford says there are many websites where patients discuss their addictions but a lack of research means there is little evidence of how big the problem is.

However the companies making the drugs argue that only a small percentage of people using the drugs abuse them.

They say the medicines are already strictly regulated, are only available from pharmacists and have clear instructions on how to use the medicine and when not to use the medicine.

Nurofen Plus is made by Reckitt Benckiser who say the drug is sold under strict guidelines and is only available in 32 pill packs.

GlaxoSmithKline, who make Solpadeine, also say there are clear instructions for use on their labels, and if these are followed there is no evidence that the product will cause dependency.

The Pharmaceutical Association of Great Britain, says OTC medicines which contain codeine or dihydrocodeine should be taken only to relieve symptoms of pain and only for short periods unless a doctor has advised otherwise.

The report is published in the British Medical Journal.