ArticlePain and therapy2016
How Resistant to Tampering are Codeine Containing Analgesics on the Market? Assessing the Potential for Opioid Extraction.
Article in Pain and therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- The Severity of Dependence Scale (SDS) for Codeine: Preliminary Investigation of the Psychometric Properties of the SDS in an Online Sample of Codeine Users From the UK.Frontiers in psychiatry · 2021Article
- Identification of factors influencing tampering of codeine-containing medicines in England: a qualitative study.Harm reduction journal · 2020Article
- Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse.Molecules (Basel, Switzerland) · 2020Review
- Interpol review of controlled substances 2016-2019.Forensic science international. Synergy · 2020Review
- Effect of codeine on CYP450 isoform activity of rats.Pharmaceutical biology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMisuse of opioid analgesics, in combination with diversion, dependence, and fatal overdoses, presents a serious problem for public health, which affects many countries worldwide. Within this context, tampering with opioids has been associated with serious harm. The aim of the present study was to assess the tampering potential of codeine combination analgesics on the market (containing codeine/non-opioid analgesics) by the extraction of codeine.
methodsCodeine was extracted from three combination formulations sold lawfully from licensed pharmacies without a medical prescription in Denmark and the UK. Extraction of codeine followed tampering procedures available on the Internet. The amounts of codeine and accompanying non-opioid analgesics in tampering products were analysed with liquid chromatography and tandem mass spectrometry (LC-MS/MS).
resultsLC-MS/MS showed recoveries of the total amounts of codeine in tampering products of 81-84% from Product 1 (codeine/acetylsalicylic acid); 61-67% from Product 2 (codeine/ibuprofen); and 42-71% from Product 3 (codeine/paracetamol). Recoveries of non-opioid analgesics ranged between: 57-73% acetylsalicylic acid; 5.5-8.5% ibuprofen, and 5.0-9.2% paracetamol.
conclusionWith the tampering procedures used, high amounts of codeine were separated from the accompanying analgesics in some, but not in all of the codeine containing formulations. Evidence-based medicine regulation, treatment for opioid dependence, and information to minimise risks to the public are essential components of an effective public health strategy to address the harms of tampering and misuse.
fundingMarie Pedersen and Jensine Heiberg Foundation.
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Registered trials
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