McCoy Jacqui, Nielsen Suzanne, Bruno Raimondo
University of Tasmania, Hobart, TAS, Australia.
Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Australia, 3199, Australia.
Addiction. 2022 Mar;117(3):677-686. doi: 10.1111/add.15683. Epub 2021 Oct 26.
To evaluate and document the impacts of re-scheduling codeine to a prescription-only medication in Australia in February 2018.
Prospective cohort study. Participants completed an on-line survey with a range of outcome measures at four time-points, once before codeine was re-scheduled (November 2017) and three times after the event: 1 month after (February 2018), 4 months after (June 2018) and 12 months after (February 2019).
Australia.
Participants were 260 Australians aged 18 years and above who reported regular over-the-counter (OTC) codeine use and, at the time of the study, were not engaged in treatment for codeine dependence.
Survey measures included estimates of daily average codeine use (mg) and overall daily average opioid use [calculated using an oral morphine equivalent daily dose (OMEDD, mg)], opioid use disorder with regard to codeine use (using a modified Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV), pain and pain self-efficacy, anxiety and depression and health service use.
A reduction in total daily codeine use (mg) from 64.3 mg [95% confidence interval (CI) = 46.7-81.9] in November 2017 (baseline) to 27.6 mg (95% CI = 19.2-36.0) in February 2019 (final time-point) was observed. A decline in the proportion of participants who met criteria for an opioid use disorder was also evident, with 51.2% (n = 133) at baseline relative to 33.3% (n = 58) at the 12-month follow-up. This study had an overall participant retention rate of 67% at the final time-point.
Re-scheduling codeine in Australia has been accompanied by significant reductions in codeine use and prevalence rates of opioid use disorder in a cohort of individuals who regularly use the medication, without apparent adverse impacts on pain or measures of anxiety and depression.
评估并记录2018年2月澳大利亚将可待因重新归类为仅凭处方使用药物的影响。
前瞻性队列研究。参与者在四个时间点完成了一项包含一系列结果指标的在线调查，一次是在可待因重新归类之前（2017年11月），事件发生后三次：事件发生后1个月（2018年2月）、4个月（2018年6月）和12个月（2019年2月）。
澳大利亚。
260名18岁及以上的澳大利亚人，他们报告经常非处方使用可待因，且在研究时未接受可待因依赖治疗。
调查指标包括每日平均可待因使用量估计值（毫克）和每日总体平均阿片类药物使用量[使用口服吗啡等效日剂量（OMEDD，毫克）计算]、与可待因使用相关的阿片类药物使用障碍（使用改良的酒精使用障碍及相关残疾访谈表-IV）、疼痛及疼痛自我效能感、焦虑和抑郁以及医疗服务利用情况。
观察到每日可待因总使用量（毫克）从2017年11月（基线）的64.3毫克[95%置信区间（CI）=46.7-81.9]降至2019年2月（最终时间点）的27.6毫克（95%CI=19.2-36.0）。符合阿片类药物使用障碍标准的参与者比例也明显下降，基线时为51.2%（n=133），12个月随访时为33.3%（n=58）。本研究在最终时间点的总体参与者保留率为67%。
在澳大利亚，将可待因重新归类后，经常使用该药物的人群中，可待因使用量和阿片类药物使用障碍患病率显著降低，且对疼痛或焦虑和抑郁指标无明显不利影响。
