AIBU to attempt an intervention of sorts?

[ToastMama]

I'll try to keep this brief.

My DM had a nasty bout of Shingles back in early 2010, leaving her with Hepatic Neuralgia as a result. She's always been pretty liberal with painkillers (has suffered from migraines and endometriosis since her 30s), but since having Shingles she's been on co-codamol 3-4 times a day for the last 5.5 years ...and then using wine every night as a "top up".

She has a prescription for the co-codamol, but prefers to buy Boots own brand as it's less salty and doesn't contain aspartame. She's known to all of our local branches, and is quizzed mercilessly on her usage every time she buys some. She asks family members to get her a pack whenever she thinks we might be going near a chemist. I used to oblige, but feel fairly reluctant to carry on.

My DM is in her late fifties, but as a result of all the pain and painkillers she now has the lifestyle, posture and attitudes of someone much older. She's permanently exhausted, struggles to spend quality time with her friends and grandchildren and yet is a bit of a matyr with the house and garden.

I'm so sad that she's suffering, as the pain from hepatic neuralgia sounds awful to live with, but I'm struggling with her use of codeine. I haven't seen the prescription, but surely if it's being prescribed then it's safe to be taking it day in day out? I just feel like she doesn't know how much pain she's really in, as the drugs have been masking it for 5yrs... But then I've never lived with a condition that would require daily pain relief.

It just makes me sad that my DM has changed so much, and I can't see anything improving for her.

AIBU to feel so uneasy about her use of codeine? And if not, to find a way to talk to her (other than gently in passing as I've already tried) about getting off the co-codamol to see if she feels better for not being pumped full of opiates?

[ditavonteesed]

you need to get her to talk to a doctor about her pain, she shouldn't be forced into a situation of self medicating.

[Spartans]

Is it still being prescribed? Are you sure ahe isn't buying it because it's no longer given by the doctor.

As the grand daughter of an addict, I was shocked to realise the lies told that seemed plausible.

Could you go speak to your GP for help. My GP was my first point of call for grandad. He pointed me in the right directions. Although in our case it took years and now he is that far gone he is going into a home this week after being found wondering the streets, in his pants.....again.

[ToastMama]

I think that's what I'm feeling unsure about. I'm not certain the prescription exists anymore... It's just such a long time for a GP to prescribe something the tell you to only take for 3 days, isn't it? Or is it normal to take high strength pain killers for years if you have an ongoing condition?

Think an appointment with my GP is a good idea.

[Bubblesinthesummer]

Or is it normal to take high strength pain killers for years if you have an ongoing condition

It can be. I am on very strong pain killers (a lot stronger than your mums) and have been for 4 years now.

They are GP and consultant prescriped and closely monitored.

[Spartans]

I honestly can't say whether it's normal or not. It doesn't seem it, but I am not sure. 5.5 years is a long time.

The thing is, I would recommend ignoring it on the off chance it's still prescribed. I really doubt it is prescribed still, which is why she goes through the questioning. She needs it but the doctor won't give her it.

What happens if the local pharmacists stop giving her it?

[gamerwidow]

My mums gp has been prescribing her co cocodamol for chronic pain for the last 3 years for daily use without review so it is possible she still has a prescription for it.
Depression often goes hand in hand with chronic pain could it be that which is causing her tiredness and change in attitude. My mum experienced a massive decline when she first started having pain and mobility issues and it's only now that she's moved to sheltered accommodation and got more support that she's gradually returning to her old self.

[Lweji]

Codeine is an opiate (opium family) and addictive. I would be concerned, yes, and wouldn't give her any.
If she is addicted, though, as she seems to be, she may experience withdrawal symptoms.
She should talk to her gp about it, although that's unlikely to happen.

Check www.drugs.com/codeine.html

[ToastMama]

Goodness knows. I tried to get her to swap just one tablet out of one of her doses for a paracetamol instead, but she said she really felt the difference and needs the codeine. I do wonder though if that's due to withdrawal as much as it is the actual pain?

In an ideal world I'd like to move her in with me, put her on bed rest type care and wean her off them. But I have two small boys, work part time and my DH is constantly travelling with work. It can't be doing her liver/kidneys/stomach any good, and it's heartbreaking that this could be what the rest of her life is like for her. Just want to do something.

[QOD]

If she's buying it, is it the 8/500 stengt as opposed to the 30/500?
I've had it on repeat 30/500 for well over a year now. I can't take NSAIDS so no other choice

[Lweji]

And she is worried about salt and aspartame but not the codeine and the alcohol at night?

[TestingTestingWonTooFree]

I agree with bubbles. You could talk to her about how she's managing. You could offer to go to the GP with her to see if there are alternatives. Hospitals run a special "pain clinic", it might be worth seeing if there's one she can go to.

[Mistigri]

Chronic pain can be difficult to manage without strong painkillers, so it's not impossible that the GP is prescribing them. IMO the use of alcohol to cope with pain is more concerning.

It sounds like your mum needs a referral to a pain clinic to help improve her quality of life. Do you think she would let you accompany her to a GP appointment?

[SoupDragon]

Is there a chance she is taking both the prescription ones and over the counter ones?

I would be very worried about addiction. I noticed an addiction warning on a pain killer advert this weekend for the first time. Although I was aware codeine is addictive, I have never seen a warning like that before.

[MushroomMama]

Codeine is very addictive. My mum was high strength painkillers for years. A new doctor put a a stop to it and now she's got liver disease and a messed up pancreas. I'd gently talk to your mum maybe spin it as getting a better painkiller to fit her pain needs.

[divegirl77]

Does sound as though she may have an issue, there are other more effective treatments for post hermetic neuralgia too. Off to the GP!

[ToastMama]

SoupDragon, I don't think so. I have occasionally seen the prescribed packs, but I think she only resorts to using her prescription when the hassle at Boots becomes too much.

I've never heard of pain clinics, that sounds exactly what she needs to do. I know she can take antidepressants or anticonvulsants as an alternative to painkillers to manage the nerve ending pain, but she doesn't want to because "they work in the brain, and you shouldn't mess with that unless you really need to".

I think I'll ask if we can go to her GP together, to ask if she can be referred to a pain clinic. I just need to word it so it comes across as supportive rather than judgemental. I don't doubt her pain is real, I just want to make sure it's being managed properly without doing any additional damage to her internal organs.

The wine is also an issue, I agree. It's 2-3 glasses a night, but on top of painkillers that can't be very good.

[SmokingGun]

Hi,

Not sure on where you are but GP's cannot refer to the pain clinic directly in South East, it has to be via a consultant. It's also s very long wait, I waited just over 5 months for my first appt and we are now very slowly trying different options.

I would also be very concerned that a GP has only perscrubed co-codomal for nerve pain, it really won't do anything! Amytriptyline would be much more appropriate. Good luck!

[bushtailadventures]

Please try and get her to see someone. My DM was addicted to soluble co-codamol and would drink the mix like water with no idea of how many she was taking. It's only when she started going through 32 in 3 days that we realised how bad the problem was. She never admitted it to the doctors though, I ended up telling them. She did get off them in the end, but it wasn't easy for her.

Good Luck!

[catfordbetty]

I know she can take antidepressants or anticonvulsants as an alternative to painkillers to manage the nerve ending pain, but she doesn't want to because "they work in the brain, and you shouldn't mess with that unless you really need to"

I take amitriptyline - an antidepressant - for neuropathic pain and find it very effective. It is prescribed in much lower doses than indicated for depression, does not have an antidepressant effect and works on the nerves themselves rather than affecting brain chemistry. Perhaps if a qualified person could explain this to your mother she might be willing to give them a go?

[familygermsareok]

It is not unusual for people with chronic pain conditions to be prescribed co codamol for years under medical supervision. However there are several other painkillers (including a patch applied to the skin) which are usually more effective for herpetic neuralgia. There are several better options the GP can prescribe and if none work then a referral to a pain clinic could be an option.

Codeine is addictive and she may need to wean off slowly.

I would also be concerned about her total daily intake. It should be no more than 8 tablets in 24 hours or she will be at risk of paracetamol overdose which can cause serious liver problems.

Her GP will be able to listen to your concerns but will not be able to discuss anything about her with you without her consent. Your own GP could give you general advice as above but would not be able to have a detailed discussion with you about another patient.
Your best way forward, if your mum will agree, would be to encourage her to see her GP and accompany her if she allows you.

It is awful to see family suffer like this. I hope you find a way forward.

[Bubblesinthesummer]

It's also s very long wait, I waited just over 5 months for my first appt and we are now very slowly trying different options.

It depends. I saw mine quite quickly.

[ohtheholidays]

I have to take opiate based painkillers for the rest of my life because of severe pain caused by chronic ill health and disabilitys,I've been using these types of painkillers for 7 years now and mine are on prescription.

Your poor Mum though,that constant nerve pain can drive you to distraction,I have a severed nerve that runs all the way from over my skull,through my neck and down through my shoulder from an accident when I was 9,sometimes it can be so severe that I vomit and then black out.

Using strong painkillers hasn't affected me in the way you've described for your Mum and I've been on morphine and desomorphine before(not at the same time)it could be the constant pain that's caused the change in your Mum.

This can help people understand what it's like for a family member or friend that lives with pain every day.

Imagine the worst pain you've ever had a bad headache,toothache,migraine now you know that eventually the pain will ease and you will be well again,now imagine having that pain and knowing there won't be any end for you,you will have to live with this pain for the rest of your life,a pain that's so engulfing that it can wake you from your sleep,it can stop you mid conversation,it can rob you of the enjoyment of simple things like reading a book or watching the tv,it can make it difficult to eat or even drink.

For alot of us living with constant pain is just what that's like.

If I was you and it was my Mum,I'd try and have a chat with her and if you think she might be taking painkillers that aren't still prescribed for her then I think it would be a really good idea to speak to her Dr if you can.Sometimes pain can be so consuming that the person that's struggling with the pain can't think straight and will end up doing just about anything they can to ease the pain.

If she is taking painkillers that aren't prescribed for her the Dr won't just take her of them(in case you have the chat with your Mum and she's worried about that)the Dr will usually lower the dose gradually to wean her of those paticular tablets and at the same time they can put in other support such as a pain clinic.

It's great that your Mum's got such a caring daughter,good luck OP,I hope your Mum gets the help she needs and that they find a way to ease her pain

[familygermsareok]

Yes, amitriptyline would be first line treatment for herpetic neuralgia. Gabapentin would be another. There may be local prescribing restrictions on this in some areas but it is commonly used in my area. GPS can refer direct to pain clinics in my area (Scotland).

[LonnyVonnyWilsonFrickett]

Your poor mum. My DSIL works in a pain clinic and this sort of thing isn't uncommon I'm afraid. It sounds to me like she is using over the counter meds to up her prescription when she needs to, which is a clear sign her prescription isn't right. The pain clinic is brilliant - specialist nurses who really know their stuff. Please push hard to get her referred.

[Maisy313]

My dad was addicted to codeine for most of my childhood and had an awful withdrawal period when it came to it. He too was topping up with alcohol and self medicating, though for psychological rather than physical pain. He later told me that he used to carry a huge bottle around in his bag and was desperate for someone to find it and confront him.