Over-the-Counter Codeine-from Therapeutic Use to Dependence, and the Grey Areas in Between

Curr Top Behav Neurosci. 2017;34:59-75. doi: 10.1007/7854_2015_422.


Codeine is a widely used analgesic, that is available for sale in pharmacies over the counter (OTC) in a number of countries including the UK, South Africa, Ireland, France and Australia. In these countries with OTC codeine sales there has been emerging concerns about misuse of and dependence on codeine containing combination analgesics, with increasing numbers of people presenting for help with codeine dependence at primary care and addiction treatment services. This has led to many countries reviewing availability of codeine in OTC available preparations, and considering possible measures to reduce harms from misuse of OTC codeine containing combination analgesics.

Keywords: Abuse; Analgesic; Codeine; Dependence; Opioid use disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / pharmacology
  • Analgesics, Opioid / therapeutic use*
  • Australia
  • Canada
  • Codeine / pharmacology
  • Codeine / therapeutic use*
  • Drug and Narcotic Control*
  • France
  • Harm Reduction
  • Humans
  • Ireland
  • New Zealand
  • Nonprescription Drugs*
  • Opioid-Related Disorders*
  • Prescription Drug Misuse*
  • South Africa
  • United Kingdom


  • Analgesics, Opioid
  • Nonprescription Drugs
  • Codeine