Over the counter (OTC) drugs can be highly addictive, warn two doctors in this week's BMJ.
The development of dependency on OTC drugs is often forgotten, write Drs Chris Ford and Beth Good. Yet, in the past three months, they describe seeing three patients with addictions to Nurofen plus (ibuprofen and codeine phosphate).
All three had started using the product for its approved indications, but their use had escalated as they became tolerant to the codeine element. Each patient presented with side effects related to ibuprofen.
Codeine phosphate is now only available on prescription but has been available over the counter in combination with aspirin, paracetamol, or ibuprofen for many years.
The authors searched the scientific literature, but could find no research into addiction to OTC drugs in the UK. Numerous websites are, however, documenting cases of addiction and offering support to those people trying to withdraw from these drugs, they say.
One website illustrates the most common addiction is to Solpadeine (paracetamol and codeine) and suggest more than 4000 people registered there currently have this problem.
There are no official statistics documenting the extent of dependence on legal non-prescription drugs, say the authors. They call for large scale research to assess and monitor the extent of the problem.