The Department of Health has issued a strong warning regarding the significant addiction potential of certain over-the-counter (OTC) medications.

Specifically, some stronger combination painkillers, which blend common drugs like paracetamol or ibuprofen with opiate derivatives such as codeine or dihydrocodeine, can be highly addictive.

Data highlights a rising trend in their consumption, with approximately 10.4 million combination painkillers dispensed by Community Pharmacies across Northern Ireland in 2024. This figure represents a 6.9% increase compared to the preceding year, indicating a growing level of demand.

Cathy Harrison, Northern Ireland's Chief Pharmaceutical Officer, stressed that addiction can affect anyone, regardless of their awareness: "Addiction can affect anyone, and often people may not even know they have an addiction. Taking over-the-counter combination painkillers should be in the short-term, no longer than three days. If you are concerned about your relationship with these types of medication, speak to your pharmacist. They are there to help."

The severity of the issue is underscored by the personal story of Michael Main, a 37-year-old man from Belfast. Michael developed an addiction to these OTC painkillers 12 years ago after initially using them to manage a leg injury and severe migraines. At the peak of his dependence, he was consuming 64 tablets daily. Recounting his struggle, he said: "I was down to four stone and I was afraid of losing my life. I knew I needed help, but I didn't know where to turn." To help others who may be unknowingly struggling, Dr Joy Watson, a Belfast Trust Consultant Addictions Psychiatrist based at the Malone Place Addiction Services Clinic, is keen to highlight the warning signs. Dr Watson stated: "We are seeing more people crossing our door to seek support with addiction to over-the-counter medication. But there are many more people in our communities who don't actually know they have an addiction. Some signs of addiction are that you may feel you need the medicine for longer periods and in higher doses than recommended, and when you do stop them you feel unwell. Addiction to these stronger combination painkillers can cause very serious health issues, including severe liver, kidney and stomach disease needing multiple surgeries and with some people ending up in Intensive Care Units (ICU). Sadly, some people have lost their lives. They can also cause issues in patient's personal or work lives."

Despite the significant risks, Dr Watson offered encouragement for those seeking help: "The good news is, there is treatment available to substitute codeine and it is highly effective. The earlier you seek the help, the better for your health. If you are concerned about your relationship with over-the-counter medication, speak to your GP or pharmacist."

The Department of Health is collaborating closely with Community Pharmacy Northern Ireland (CPNI) to raise awareness of the issue. Leaflets and posters have recently been distributed to all Community Pharmacies and GP surgeries to inform the public about the risks of addiction.

Katherine Kidd, Head of Professional Services at CPNI, underscored the role of pharmacists: "Community pharmacists are medicines experts, and they can support patients to find out more about the over-the-counter medication they are taking or thinking of starting, including the potential side effects, to help encourage safe and appropriate use. If a patient has any queries or concerns about these types of medicines, I urge them to speak to their community pharmacist who can help support their appropriate use."

www.drugsandalcoholni.info