To think I should be able to get co-codomol on presciption

[Ryderryder]

It is likely that it will need to be taken day for up to a year. On the face of it it seem cheap. Between £1.70 and £3.00 a pack. However one pack last a 4 days. Also buying ibruphom (sp) which is 35p every 2 days.
Aibu

I've been on Co codamol 30/500 for years, for chronic pain. Gp prescribes 100 at a time which last me 3-4 weeks. I also buy the lower strength 8/500 which I use when the pain isn't too severe.
I probably am addicted to them but no other painkillers work as well.
Just be careful with them op

I’m on 30/500 2x4 daily, naproxen 250mg x 2 daily, MST 45mg x 2 daily, and oramorph. Have been for 8 years. So I get over 200 strong co-codamol’s monthly.

If your doctor says it’s fine to take them then listen to them. Most people have a fit when they find out how much I take, but it’s under GP, Consultant and Pain Clinic guidance.

I hope they help you!

The GP could certainly prescribe you with co-codamol. It isn't meant to be used for more than 3 days though , so as it's long term pain(not short ie waiting for dentist appointment) it's pretty rubbish to direct you to OTC. Not great to get it OTC even with pharmacists advice. And pharmacies will cotton on and refuse you if you're a repeat customer buying OTC opiates regularly. If it's for long term pain, your GP should be giving you a prescription

However there are other ways of controlling pain beside using cocodamol, which is incredibly addictive. Your GP should be exploring all options with you, not just telling you to rely on OTC cocodamol, which aren't very strong anyway.

Go back to GP and reiterate that you're in pain. That the pain will be for a while as surgery is a long way away. That you know cocodamol isn't advised for longer than 3 days and you'd be using is longer than that - is it safe? Ask him to suggest other pain medication. Also explain that if cocodamol is the best way then fine, but if it's long term you need a prescription. Not necessarily for the cost aspect, but you know pharmacies refuse repeat buyers and you don't want any issues.

There are ways of sourcing cocodamol online, it's quite easy. But im not going to say as it is dangerous. You need to return to your GP and get it sirted

GP just needs to prescribe movicol or whatever to prevent constipation. More prescribing needed, not less!!

Thank you. Will book an appointment.

What's happening in a year?

I get co-codamol on prescription as I have a condition that causes intense pain and I can't take NSAIDs but it's stronger than anything you can buy over the counter.

It has side effects such as constipation and even though I've been on and off it for years still can get spaced out on them

Try to take other painkillers if you can

I get 2 different strength cocodamol on prescription. 15/500 & 30/500. They do occasionally cause constipation but only now & again. Id try going back to the GP again.

Hope you manage to get an appointment soon OP. I take cocodamol daily for chronic pain and it really is better supervised under a GP because of the addictive nature of it. I take 30/500 up to 6 a day.

What I've been told in the past is I need to be taking the maximum of the 15/500s before they'll introduce the 30/500s i.e. you need to be prescribed and taking 8 a day for several months. The 30/500 tablets for me were introduced as less than 8 per day as they expected me to only take one at a time and occasionally take 2 to get the full 60 mg if that makes sense?

Anyway point being is go see a different GP and don't stop pushing for pain relief. I know how hard it is and how dismissive some GPs can be. Have you ever tried naproxen? That may be another option if they're worried about constipation although naproxen leads to a whole other set of side effects 🙈

I agree with @SlowlyShrinking re movicol. I'm on Laxido to counteract the constipation - there are ways around the side effects such as these.

Any painkillers that you don’t need a prescription for should be bought from a shop. Saying that. OTC meds’ don’t work for my arthritis so I can only get on perscripn. It would be inconvenient getting it from a shop for me as GP prescribes 200 in one go for me as I take every day

I chemist hop a lot for dh pain killers as we have lots of shops in town that sell them.
If it's normal strength ibuprofen I get a couple of packs in each shop. Poundshop lets you buy 3 packs for £1, same with paracetamol.
If you can afford it all in one day you can get a few months supply by using all the shops.

I'd go back to gp about the co-codamol and if they say over the counter, I'd do the same.

Try online pharmacy. Expensive but delivered to your door while you wait for gp appointment

I get 100 tablets on prescription for pain, the 30 (stronger) kind. on repeat.

I probably am addicted to them but no other painkillers work as well.

There's a difference between tolerance, dependence and addiction

I've been on long term opioid therapy (strong opioids including morphine, oxycodone and fentanyl) for 18 years under the care of a pain consultant

I need more of the drug to have the same pain killing effect, because the opioid receptors in my brain have got de-sensitised over time. This is tolerance. This is not addiction.

Because my body is used to taking the opioids, I may go into withdrawal if I don't taper off slowly. This is physical dependence. This is not addiction

Addiction is a psychological dependence on the meds, when you take them not for their analgesic effect but for a pleasurable effect, because of a psychological compulsion - an irrational persistence despite negative consequences.

Opioids aren't ideal for long term pain control and a pain clinic will be able to advise multiple different modalities for pain management. Opioids can be addictive - but tolerance and dependence isn't the same as addiction.

I hope your GP can advise and if necessary refer you to a pain clinic

Addiction is a psychological dependence on the meds, when you take them not for their analgesic effect but for a pleasurable effect, because of a psychological compulsion - an irrational persistence despite negative consequences.

With absolute respect, I disagree. Whilst you're quite right about the psychological compulsion, physical addiction is very real. Once you develop a physical dependence on a substance - be it painkillers, alcohol, street drugs - it tips over from psychological into physical.

As a long time recovering alcoholic, now working as a psychotherapist specialising in addiction, the withdrawal symptoms from certain substances are extreme, agonising, and in no way purely psychological.

This is physical dependence. This is not addiction

I disagree with this statement too. Physical dependence due to sensitisation of your receptors is an addiction according to neuroscience. But hey don't let good old science dissuade you from your opinion.

You shouldn't be taking ibuprofen long term. I have chronic pain and don't suit many NSAIDs like diclofenac so have had LONG discussions on pain relief with GPs, specialists etc. I have the fewest side-effects with ibuprofen but the GP said no because of the risk of stomach bleeds. There are slightly safer NSAID alternatives (and you can also be prescribed omeprazole which helps protect your stomach). I think you need to find a different GP, one who will optimise your pain relief with you.

I also take highest strength (30/500) cocodamol, though it's separated into paracetamol and codeine, so I can refine my dosage, but it's addictive and should be under the supervision of your GP. Knowing how much the meds cost I tried to buy the paracetamol from pharmacies but it was a nightmare due to the (sensible) restrictions, and pharmacists getting concerned because I was in there so often.

Constipation is an issue with cocodamol, but if it's needed for pain relief then that usually seems to supersede, though I imagine if you had anal fissures or something, or chronic constipation generally, they might look for alternatives.

You really need a more sympathetic GP.

@PoesyCherish, that's right. Addiction also fails to be pleasurable, it rapidly turns into a physical need for that particular substance. Pleasure left a long time ago, once addiction set in.

I'm on 30mg plain codeine pills, not mixed with paracetamol. Paracetamol makes me throw up if I take it repeatedly. I'm also on amitriptylene to help with my fms nerve pain, and venlafaxine for my depression. I take so many meds, I have to also take omeprazole to stop severe reflux and stomach ache, and antiemetics for sickness. I have a super strength laxative which comes in a tiny yellow pill, forgotten it's name. But it's the kind you take, then practically shit yourself. It's good. Your GP could help with this sort of thing but is choosing not to. See a different GP.

I disagree with this statement too. Physical dependence due to sensitisation of your receptors is an addiction according to neuroscience. But hey don't let good old science dissuade you from your opinion.

OK I stand corrected. I am simply repeating what I've been told by the consultant pain specialists who have treated me over the years but I'm happy to be corrected by others with greater understanding than me. This is how long term opioid therapy and the down regulation of my opioid receptors has been explained to me:

Definitions Related to the Use of Opioids for the Treatment of Pain: Consensus Statement of The American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine

Addiction
Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Physical Dependence
Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

Tolerance
Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time

I have no opinions on the matter as I'm not a neuroscientist - happy to defer to those with superior knowledge.

YABU. At your pharmacy what hoops do you have to jump through exactly? And if shops limit it to 2 packs of 16 go through the tills a few times? I do it all the time on self service tills. Put two through, pay, put two through etc.

Do you get free prescriptions? Otherwise I can't see the cost argument.

As for the inconvenience, suck it up. You have something that works, I and many others would love to be able to buy something that makes the pain manageable but can't. If I could nip out to buy steroids for me to function, I wouldn't be moaning about the cost and inconvenience I'd be delighted.

If I've read the posts wrong, and you genuinely can't afford it, apologies, but otherwise, count your blessings and get on with it.

I'd advise you to see another gp maybe? Are you after the stronger ones?

I think it depends on the doctor. When I was in Spain I developed a painful uti and as well as ab's the doc I saw prescribed tramadol for the pain. I was too scared to take them though! Just carried on with my Co codamol as normal.

Pharmacy will only supply for 3days use. So if we return they could refuse to sell it. Likely to need either joint replacement surgery or injections under GA if they refuse to replace as only 45.

If you are on crutches and in pain than trawling around different pharmacies is very inconvient.