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Long-Term Codeine Use Is Associated With Depressive Symptoms

Romach, Myroslava K. MSc, MD; Sproule, Beth A. PharmD; Sellers, Edward M. MD, PhD; Somer, Gail MA; Busto, Usoa E. PharmD

Journal of Clinical Psychopharmacology: August 1999 - Volume 19 - Issue 4 - p 373-376
Brief Reports

A community survey was conducted among long-term (>6 months) users of codeine-containing products to characterize chronic use of these extensively consumed medications. Respondents recruited through newspaper advertisements completed a mailed questionnaire. Three hundred thirty-nine completed questionnaires were obtained, yielding a response rate of 70%. Codeine dependence/abuse as defined by DSM-IV criteria was present in 41% of the respondents. Two thirds of the subjects had sought help for mental health problems, most often depression (70%). Scores on the Symptom Checklist-90 subscales were modestly elevated, particularly on the Depression subscale (1.2 +/- 0.9). Long-term codeine use is strongly associated with dependence. Depression and depressive symptoms are common. These data suggest that dysphoric mood states may be significant in maintaining long-term codeine use. (J Clin Psychopharmacol 1999; 19:373-376)

Departments of Pharmacology, Medicine, and Psychiatry, and Faculty of Pharmacy, University of Toronto; Centre for Addictions and Mental Health, Toronto, Ontario, Canada

Received November 17, 1997; accepted after revision August 17, 1998.

Presented at the Annual Meeting of the Committee on Problems of Drug Dependence, San Juan, Puerto Rico, June 1996. Supported in part by National Institute on Drug Abuse Grant #DA06899.

Address requests for reprints to: Myroslava K. Romach, MSc, MD, Psychopharmacology and Dependence Research Unit, Women's College Hospital, 76 Grenville Street, Toronto, Ontario, Canada M5S 1B2. Address e-mail to:

© 1999 Lippincott Williams & Wilkins, Inc.