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‘For pain, no shame’ and ‘My secret solace’: accounts of over-the-counter codeine dependence using Q methodology

Citation

Kirschbaum, M and Barnett, T and Cross, M, For pain, no shame' and My secret solace': accounts of over-the-counter codeine dependence using Q methodology, International Journal of Drug Policy, 73 pp. 121-128. ISSN 1873-4758 (2019) [Refereed Article]

Copyright Statement

© 2019 Elsevier B.V. All rights reserved.

Abstract

Background: Dependence on over-the-counter (OTC) codeine is recognised internationally as a rising public health issue. The effectiveness of health intervention strategies may be influenced by the beliefs held by those who are dependent. Applying Q methodology, this study aimed to identify shared accounts of OTC codeine dependence.

Methods: Twenty-six participants from Tasmania, Australia, met eligibility criteria for the study as long-term OTC codeine users with a Severity of Dependence Score of five or higher. Forty-six opinion statements about OTC codeine dependence were sourced from the literature and online discussion forums. These were rank-ordered by participants from least to most agree and explanatory comments for the most strongly positioned statements were provided. By-person factor analysis was used to group participants who had sorted the statements similarly.

Results: Two distinct accounts of OTC codeine dependence were identified. Participants representing Factor One, ‘For pain, no shame’, were not ashamed of their OTC codeine use, believed access should not be restricted and regarded it as necessary for the relief of physical pain. In contrast, Factor Two, ‘My secret solace’, was characterized by feelings of guilt and shame. Participants in this group intentionally used codeine for its effects on mood; to help them relax and to relieve stress, rather than solely for pain relief. They did not consider regular use of codeine to be socially acceptable and hid their use from others.

Conclusion: The way in which OTC codeine use is viewed by those who are dependent is not uniform. Two distinct accounts were identified in this sample. Participants from each group varied in their beliefs about access, causality, reasons for use and feelings of legitimacy and shame. An understanding of these differences can be used to better target interventions and guide policy for the prevention and management of OTC codeine dependence.

Item Details

Item Type:Refereed Article
Keywords:codeine, substance abuse, dependence, Q methodology
Research Division:Medical and Health Sciences
Research Group:Other Medical and Health Sciences
Research Field:Medical and Health Sciences not elsewhere classified
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Substance Abuse
UTAS Author:Kirschbaum, M (Mr Mark Kirschbaum)
UTAS Author:Barnett, T (Associate Professor Tony Barnett)
UTAS Author:Cross, M (Dr Merylin Cross)
ID Code:135674
Year Published:2019
Deposited By:Centre for Rural Health
Deposited On:2019-11-07
Last Modified:2019-12-09
Downloads:0

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