Codeine accounts for 60% to 75% of total oral opioid use . Prescription use of codeine has been increasing slowly in the past few years, while nonprescription use has remained stable . When these medications are prescribed inappropriately or misused by the patient, they can lead to dependence and interdose withdrawal headache . One of the few studies published looking at the use of analgesics in patients with headaches showed that, of patients with daily or near daily headaches, 40% took codeine-containing products (on average 28 tablets/week) and 65% took two or more different preparations for symptomatic relief.

In Canada, the codeine-containing product Tylenol #3 was the most widely prescribed drug from 1992 to 1994 and was the second most prescribed drug in 1995 . Thus, it is not surprising that 92% of oral prescription opioid-dependent patients identified in a study at the Addiction Research Foundation (ARF) were found to use codeine or codeine-containing products . The severity of dependence on codeine varies widely, and mild physical dependence is most common. In a survey of regular users of codeine (excluding cancer patients), 30% (102 of 339) self-identified problems with codeine use and 37% met criteria for dependence outlined in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised (DSM-IV-R) . Most commonly reported symptoms were tolerance, withdrawal, difficulties stopping and use for longer than intended. Despite these few studies, severe oral opioid dependence (prescription and over-the-counter) has not been adequately or systematically studied. The primary purpose of this study was to characterize the demographics, patterns of drug use and treatment outcome of patients severely dependent on oral opioids. It’s your turn to find cheap asthma medications to see how advantageous your shopping can be.