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Abstract

Introduction and Aims: There is international concern about misuse of over-the-counter (OTC) codeine, yet few studieshave reported the perspectives of misusers themselves. This study explored the experience of OTC codeine misuse and recoveryin Tasmania, Australia. Design and Methods: Semi-structured telephone interviews were conducted with 15 self-identifiedlong-term users of OTC codeine. The interview guide prompted responses about reasons for codeine use, positive and negativeimpacts, recovery, identity and codeine accessibility. Transcripts were analysed abductively using qualitative content analysis.Categories that emerged from misuser accounts were aligned to three broad temporal phases: (i) transition to misuse;(ii) growing awareness; and (iii) towards recovery. Results: Salient features of the misuse experience included: initial use forthe self-treatment of physical pain; ongoing use to self-medicate physical pain, stress or mental health conditions; a perceptionof safety of OTC codeine; an insidious transition from use to misuse; growing awareness of a problem over time; support provided by family, friends and the internet; recovery through self-change; and recognition that recovery is an ongoing process. Discussion and Conclusions: Knowledge and understanding of the experience of OTC codeine misuse and recovery iscritical to inform and tailor approaches to prevention and intervention. The findings suggest that strategies to improve themanagement of pain, stress and mental health, raise self-awareness of problematic use and potential for self-change, andincrease social and web-based supports, should be considered when designing health policy initiatives that aim to reduce misuse.

Item Type:	Article
Authors/Creators:	Kirschbaum, M and Barnett, T and Cross, M
Keywords:	codeine, substance abuse, qualitative research, addiction, recovery
Journal or Publication Title:	Drug and Alcohol Review
Publisher:	Carfax Publishing
ISSN:	0959-5236
DOI / ID Number:	https://doi.org/10.1111/dar.13081
Copyright Information:	Copyright 2020 Australasian Professional Society on Alcohol and other Drugs
Related URLs:	Google Scholar: Barnett, T UTAS Profile: Barnett, T Google Scholar: Cross, M UTAS Profile: Cross, M
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