Use of codeine-containing medicines by Irish psychiatric inpatients before and after regulatory limitations on their supply.

Background In recent years, concerns have been highlighted in several jurisdictions, including Ireland, regarding abuse of over-the-counter codeine-containing medicines. On the 1st of August 2010, national regulatory guidelines aimed at limiting the supply of these medicines in Ireland came into force. Aims To study the effects of the new regulations on the use of non-prescribed codeine-containing medicines by psychiatric patients admitted to an Irish university teaching hospital before (n = 117) the regulations came into effect and 6 months afterwards (n = 126). Methods Participants completed a brief self-administered survey questionnaire about their use of over-the-counter codeine-containing medicines in the preceding 3 months. Results Compared with before the introduction of the new regulations, there was a large decline in the reported ‘often’ or ‘regular’ use of codeine-containing medicines in the 3 months before admission (33.3% v. 17.4%, χ2 = 6.354, p = 0.01) and there was a reduction in the proportion of patients for whom others had expressed concerns about their frequency of use of such medications (15.5% v. 4.8%, χ2 = 7.29, p = 0.03). There was also a decline in the proportion of patients who stated that they would use codeine-containing medicines for either a ‘feel-good’ effect or to curb cravings (15.9% v. 1.9%, p < 0.01, two-tailed Fisher's exact test). Conclusion We conclude that tight regulations on the supply of non-prescription codeine-containing medicines have the potential to reduce the use and abuse of such medicines in patient populations availing of admission to psychiatry hospitals

Use of codeine containing medicines by Irish psychiatric patients before and after the introduction of regulations on their supply.

On the 1st of August 2010 guidelines aimed at ensuring the safe supply of over-the -counter codeine containing medicinal products came to force in Ireland. Objectives: The study aimed to examine the frequency of use as well as reasons for the use of non-prescription codeine containing medicines in an Irish psychiatric population before and after the introduction of regulations on the supply of codeine containing medicines. Methods: Self administered questionnaires were designed and administered to patients before and after the introduction of guidelines regulating the sale of non-prescribed codeine containing medicines in Ireland. The results were compiled and analysed using descriptive statistics and chi-square test. Results: Significantly more patients reported that they often or regularly used codeine containing medicines before the introduction of the regulation compared to the period after that(33.3% vs. 17.4%, x2=6.354, p=0.01). Significantly more patients also reported that others had expressed concerns about the frequency with which they used codeine containing medicines before the introduction of the regulation compared to the period after the introduction of the regulation (15.5% vs. 4.8%, x2=7.29, p=0.03). Finally, significantly more patients stated that they would use codeine containing medicines either for the ‘feel good’ effect or to curb cravings before the introduction of the regulation than after the introduction of the regulation (15.9% vs. 1.9%, p=0.00). Conclusion: Tight regulations on the supply of non-prescription codeine containing medicines have the potential to reduce the abuse of such medicine among psychiatric patients in general

Heavy metal poisoning as a possible cause of massive fish mortality and mongoose in the gold mining area around Khutsong, North west province , South Africa

Abstract: Ten composite samples each of water, sediment, fish and organs samples of mongoose from the Wonderfontein area were analysed for the presence of As, Pb, Cd and Cr using atomic absorption spectrophotomery in order to investigate the massive fish mortality in the Wonderfontein stream. Follow up samples of water and sediment were similarly analysed a year later. Abundance of metals followed the trend As&gt;Pb&gt;Cd&gt;Cr, Cr&gt;As&gt;Pb&gt;Cd and As&gt;Cd&gt;Pb&gt;Cr in water, fish and mongoose respectively. The concentrations of As, Pb, Cd and Cr in the initial water samples were 510, 121, 90 and 73 ppm respectively. Water samples collected 12 months later had lower levels of metals at 256, 60, 60, and 50ppm respectively. Cr was highest in fish samples at 56 ppm, while As was highest in mongoose kidney at 25.7ppm. Water concentrations of As, Pb, Cd and Cr were 10 205, 8 020, 2 425 and 733 times higher than the EC/WHO/EPA recommended threshold for potable water while those of Cd and Pb were 36 and 11.2 times higher than those recommended for fish. Levels of metals in sediments were generally higher than those in water. Severe heavy metal pollution with As, Pb, Cd and Cr was revealed in this study, and was also most linked to the mortality of fish and mongoose in the stream. Frequent biomonitoring is therefore recommended in order to safeguard public and animal health in the area. [Nyirenda M, Thekiso V.V, Dzoma B.M, Motsei L.E, Ndou R.V, Bakunzi F.R. Heavy metal poisoning as a possible cause of massive fish mortality and mongoose in the gold mining area around Khutsong, North west province, South Africa. Life Sci J 2012;9(3