Nod and wave: an Internet study of the codeine intoxication phenomenon.
International Journal of Drug Policy January 2015 DOI: 10.1016/j.drugpo.2014.06.016 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Population | Recreational drug users posting on public internet forums about sole codeine use |
| Topics | Philosophy of mind |
| Keywords | Codeine Indigenous harm reduction Internet |
| Key findings | Forum users described transitions between medical and non-medical codeine use and shared harm-reduction tactics, including moderated use, informed dosing schedules, cold water extraction, and using codeine as an alternative to stronger opioids. The authors argue that internet drug forums drive communal know-how and indigenous harm reduction strategies and warrant consideration as public health mechanisms for informing users. |
Abstract
The non-medical use of pharmaceutical opioids such as codeine is of increasing public health concern. The aim of the study was to describe codeine intoxication experiences amongst recreational drug users, as posted on public Internet forums. Internet searches were carried out by using the specific key word 'codeine' and in combination with 'experience', 'report', 'trip' and 'forum'. 96 Trip reports and 156 thread discussions relating to the sole use of codeine were analysed using the empirical phenomenological psychological (EPP) method. Nine themes and 72 categories emerged. Narratives illustrated transitions between medical and non-medical use of codeine for dulling of emotional and/or physical pain, opiate withdrawal management and for intoxication. Codeine's appeal centred on access via family medicine cabinets, prescribers and pharmacies. Discussion and dissemination of indigenous harm reduction tactics included the learning to appreciate codeine's effect via moderated use in optimal settings, avoidance of tolerance by use of informed dosing schedules, cold water extraction of codeine, and using codeine as an alternative to stronger opioids. Oral and rectal routes were favoured, with awareness on forums of the harms of intravenous and subcutaneous injection. 250 mg was recommended to optimise recreational outcomes. Forum users describe potentiating practices and using over-the-counter medications to improve intoxication experiences and reduce unpleasant side effects. Dissociative effects, ability to ignore physical and emotional pain, codeine induced synaesthesia and altered states of consciousness were described. Overdose was characterised by anaesthesia, severe chest and stomach pain, respiratory depression, panic and fear of death. Efforts to ensure legitimate codeine use for pain and reduction of aberrant behaviours centre on evidence based screening, risk minimisation, prescription monitoring and specific treatment protocols. This study shows that internet drug forums drive communal know-how and indigenous harm reduction strategies, and warrant consideration as viable public health mechanisms for informing users.
Comparable studies
Other qualitative studies on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Qualitative thematic analysis of the phenomenology of near-death experiences Cardiac arrest survivors | 2018 | Qualitative study | n = 34 |
| Phenomenology and Sequelae of 3,4-Methylenedioxymethamphetamine Use Psychiatrists who had taken MDMA | 1992 | Qualitative study | n = 20 |
| A phenomenology of meditation-induced light experiences: traditional buddhist and neurobiological perspectives American Buddhist practitioners | 2014 | Qualitative study | |
| Evoking the ineffable: The phenomenology of extreme sports. Extreme sports participants across three continents, including BASE jumping, big wave... | 2017 | Qualitative study | n = 15 |
| Phenomenology and content of the inhaled N, N-dimethyltryptamine (N, N-DMT) experience. Naturalistic inhaled N,N-DMT experiences posted to the r/DMT Reddit community | 2022 | Qualitative analysis | n = 3,778 |
Citations in the library
Cites 7
- Recreational MDMA use in Sydney: a profile of ‘Ecstasy’ users and their experiences with the drug British Journal of Addiction August 1, 1992
- 'Surfing the Silk Road': a study of users' experiences. International Journal of Drug Policy November 1, 2013
- Methoxetamine (MXE) – A Phenomenological Study of Experiences Induced by a “Legal High” from the Internet Journal of Psychoactive Drugs July 1, 2013
- Reducing the risks of drug use: The case for set and setting Addiction Research & Theory June 1, 2005
- Heaven and Hell—A Phenomenological Study of Recreational Use of 4-HO-MET in Sweden Journal of Psychoactive Drugs July 1, 2011
and 2 more in the library