Over-the-counter (OTC) medicine dependence
I graduated from the University of Aberdeen with a First Class in BSc Health Sciences in 2010, and a Commendation in MSc Health Services and Public Health Research in 2011. For my BSc research project I had the opportunity to conduct research in any area I wanted. I chose substance use as it was something I knew very little about but thought would be interesting to learn about. I conducted a national survey of specialist clinicians’ practice and views regarding the supervised consumption of methadone and their use of contingency management. I was awarded the Elizabeth Russell Prize for Best Honours Project Thesis from the Health Science projects in 2010. I conducted a systematic for my MSc dissertation review which looked at changes in mental health during opiate replacement treatment. For my PhD I decided stay within the field of substance use and addiction but to focus on a different topic: over-the-counter (OTC) medicine dependence.
PhD project aims
The aims of my PhD are to determine the prevalence of self-reported OTC medicine misuse, abuse and dependence in the UK, to identify the barriers and enablers to seeking treatment for OTC medicine dependence, and to establish how OTC medicine dependence is managed by substance misuse treatment providers.
Background literature/previous work
Much of the previous research focuses on pharmacists’ perceptions of OTC medicine misuse (1, 2, 3, 4, 5, 6). Research focusing on self-reported outcomes tends to be highly specific in terms of the population or the outcome measured, for example, people aged 12-25 from the United States who reported using non-prescribed cough and cold medicines to “get high” (7).
Qualitative research involving people with OTC medicine dependence found that there was considerable variation in the perceived benefit of various treatment and support options used by participants; attempts at self-treatment were often ineffective and experiences with general practitioners varied considerably. Specialist treatment services were perceived as not being set-up to treat OTC medicine dependence. Additional concerns regarding the need for confidentiality and anonymity were also raised in relation to treatment options (8). Nielson and colleagues explored the pathways from therapeutic to problematic use, patterns of use and product preferences, harms experienced, and experiences of treatment (9). Based on their findings, they listed “identifying and addressing the barriers to treatment” as a key recommendation for further study.
Due to the limitations of the existing literature, a general population survey was designed to determine the prevalence of OTC misuse, abuse and dependence in the UK. Semi-structured interviews based on the Theoretical Domains Framework (10) were designed to identify the barriers and enablers to seeking treatment for people who are dependent on OTC medicines. A survey of substance use treatment providers was developed to establish how OTC medicine dependence is managed.
Work plans and timeline
I commenced my PhD in October 2012. I have finished conducting a general population survey to determine the prevalence of OTC medicine misuse, abuse and dependence in the UK. I am currently conducting semi-structured telephone interviews with people who are dependent on OTC medicines to identify the things that help and hinder seeking treatment for their dependence. Next I will be conducting a survey of substance use treatment providers to find out how OTC medicine dependence in treated. I aim to complete my PhD in September 2015.
(PhD project – abstract) Fingleton, NA., Matheson, CI., Watson, M. & Duncan, E. (2014). ‘Non-prescription medicine misuse and dependence in the UK: a general population survey’. International Journal of Pharmacy Practice, vol 22, no. Supplement 1, pp. 8. [ONLINE] DOI: 10.1111/ijpp.12101=
(MSc project – manuscript) Fingleton, NA., Matheson, CI. & Jaffray, M. (in press). ‘Changes in mental health during opiate replacement therapy: A systematic review’. Drugs: education, prevention and policy. [ONLINE] DOI: 10.3109/09687637.2014.899986
(BSc project – manuscript) Fingleton, NA., Matheson, CI. & Holland, RC. (in press). ‘Specialist clinicians’ practice and views regarding methadone/buprenorphine supervision and contingency management: a national survey’.Journal of Substance Use. [ONLINE] DOI: 10.3109/14659891.2013.858781
Relevance of your work for the field
My work adds to the knowledge in relation to OTC medicine dependence, which is currently limited. My research is the first to determine the prevalence of OTC medicine dependence in the UK general population. The interviews with people dependence on OTC medicines will identify the barriers and enablers to seeking treatment; this should help identify what needs to change so that this is easier in the future.
The SSA has helped greatly by providing awarding me with a studentship, without which I would not have been able to conduct this research. Doing a PhD has enhanced my understanding of conducting research and the intricacies of scientific studies whilst equipping me with the necessary skills in quantitative and qualitative methods. In particular by working across health sciences and health psychology I have learned about the application of theory to research design.
Albsoul-Younes A, Wazaify M, Yousef AM, Tahaineh L. Abuse and misuse of prescription and nonprescription drugs sold in community pharmacies in Jordan. Subst Use Misuse 2010;45(9):1319-1329.
Hughes GF, McElnay JC, Hughes CM, McKenna P. Abuse/misuse of non‐prescription drugs. Pharmacy World & Science 1999;21(6):251-255.
Matheson C, Bond C, Pitcairn J. Misuse of over-the-counter medicines from community pharmacies: a population survey of Scottish pharmacies. Pharmaceutical Journal 2002;269:66-68.
MacFadyen L, Eadie D, McGowan T. Community pharmacists’ experience of over-the-counter medicine misuse in Scotland. The Journal of the Royal Society for the Promotion of Health 2001;121(3):185-192.
Pates R, McBride AJ, LI S, Ramadan R. Misuse of over-the-counter medicines: a survey of community pharmacies in a South Wales heath authority. Pharm J 2002;268(7184):179-182.
Paxton R, Chapple P. Misuse of over-the-counter medicines: a survey in one English county. Pharm J 1996;256(6881):313-315.
Substance Abuse and Mental Health Services Administration. The NSDUH report: Misuse of over-the-counter cough and cold medications among persons aged 12 to 25. Rockville, Maryland: Substance Abuse and Mental Health Services Administration; 2008.
Cooper, R. J. (2013). ‘I can’t be an addict. I am.’Over-the-counter medicine abuse: a qualitative study. BMJ open, 3(6).
Nielsen, S., Cameron, J. and Pahoki, S. (2010) Final report 2010: Over the counter codeine dependence, Victoria: Turning Point Alcohol and Drug Centre.
Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D. and Walker, A. (2005) “Making psychological theory useful for implementing evidence based practice: a consensus approach”, Quality and Safety in Health Care, 14(1), pp. 26-33.