60% rise in elderly patients being prescribed codeine

The figures were provided in response to a parliamentary question from TD Colm Burke after it was revealed over a million prescriptions were issued for codeine last year, a 22% jump over the last ten years. Picture: Gareth Chaney/Collins

The number of elderly patients being prescribed highly addictive codeine has soared by 60% in the past decade.

A senior geriatrician has called for re-evaluation of the reduced use of non-steroidal drugs, and for limits on waiting times for hip and other surgeries.

Latest figures from the HSE show that 435,621 over-70s were prescribed codeine products last year through the three main public drug schemes. This is compared to just 272,439 people in the same age category in 2011.

The number of over 75s being prescribed codeine through the Drug Payment Scheme is almost eight times the number of people in that age bracket who were on it in 2011 (from 4,380 to 32,067). Meanwhile, the number prescribed codeine products through the General Medicine Scheme in that same age bracket rose from 184,543 in 2011 to 268,283 in 2022.

There was a drop, however, in the numbers under 35 years of age being prescribed codeine.

The figures were provided in response to a parliamentary question from Fine Gael TD Colm Burke after it was revealed last month that over a million prescriptions were issued for codeine last year, a 22% jump over the last ten years.

Codeine is highly addictive, with a study released recently by the Health Research Board revealing that codeine products account for the largest number of drug treatment cases involving people from affluent areas.

The figures have been provided as a review of the sale of over the counter medicines containing codeine is being undertaken by the Health Products Regulatory Authority.

Consultant geriatrician Professor Rónán Collins said the increase in use of codeine could be explained by a focus on reducing the use of non-steroidal drugs like ibuprofen, Difene, and Voltarol.

"There has been an encouragement not to use those drugs so much because of side effects on people's kidneys and on people's stomachs," he said.

He said that doctors are aware that while codeine is an effective painkiller, there are concerns that people can become dependent on it and that there are side effects to it. He said:

Alleviation of pain is important. I think we need a discussion about that as well in terms what are the most appropriate and effective ways to relieve individuals' pains.

"For example, one of the issues that should be discussed is — were non-steroidals as bad as we made them out to be?

"The second discussion is that if we have an increase in our older population, I think we should be setting guidelines on how long a person has to wait to have their hips done for example, and we need to be sticking to it".

People are waiting for procedures that might offer a better non-medical alternative.

Dr Collins said that ageing is associated with painful conditions including arthritis, neuropathy, and post stroke pain. He pointed to the growth in the population of people over the age of 65, which would translate to an increase in figures being prescribed codeine.

The 2022 census recorded that the highest increase in the population was in over 70s, at 26%.

Mr Burke said he sought the information because of concerns raised about possible dependence by patients on codeine medication.

He said that prescription of such medication for under 18s has been reduced "quite dramatically".

He echoed Prof Collins's assertion in relation to the growth of the older population in Ireland.

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