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AIBU?

AIBU to be concerned G.P has prescribed DH co-codamol for long term pain relief

139 replies

Hangingwithmygnomies · 11/10/2022 18:40

Obviously will start by saying I am clearly not a health professional but my DH has a problem with a couple of vertebrae in his neck, something akin to bulging disks. It's a chronic condition and basically he has been told that nothing can be done so it's just long term pain management. He was precribed amitriptyline but he felt they made him an angry person and didn't like it, so he spoke to the G.P and they've now precribed co-codamol. I feel really uneasy about it as whenever I've bought it for migraine, the pharmacist has told me not to take it for more than 3 days so didn't think it was suitable for long term relied. Also I had a friend who became fully addicted to codene after taking co-codamol for an injury and sadly the addiction over took her completely and she took her own life, so I am aware my opinion maybe clouded due to this and would welcome other perspectives to see if IABU or not

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TheHateIsNotGood · 11/10/2022 21:25

For back pain, etc my first port of call has always been an Osteopath. I have done this for nearly 40 years and never resorted to prescribed medicine for what are mostly physical problems.

If you've got X-rays that explain the source of pain then maybe you need a Chiro, but I've never used one myself.

I'm not anti-medicine nor agin surgically invasive techniques at all - probably wouldn't be alive without them, but Osteopathy isn't 'quackery' and really should be considered.

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Daisydoodo · 11/10/2022 21:32

I am currently tapering from 8 max strength a day I have been on them for 6 years and really struggle with dependence now. I have managed to cut down to 6 so far but it’s difficult when you rely on them.

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Hangingwithmygnomies · 11/10/2022 21:34

Miiaaoow · 11/10/2022 21:21

This is physical dependency, which is a world away from addiction when we are talking about opioids.

Most people on opioids, gaba drugs and anti depressants (hell, even caffeine!) will develop physical dependency and thus develop withdrawal when they stop.

People (not you, everyone) need to separate dependency and addiction, they are not the same thing.

I guess the issue for me is our friend was originally taking it for valid reason, for an injury she sustained but that developed into physical dependancy and then full blown addiction. I know addiction doesn't discriminate but she was a very well educated, professional woman and I just never saw it coming. We didn't realise how bad it was until it was too late, so how do you know if someone is becoming addicted? I

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MrsMorrisey · 11/10/2022 21:37

I think there is a place for alternative pain management plans however it has to be an individual process.

My father had a terrible accident years ago and took painkillers initially and then weaned off them as he did other therapies.

In saying that he is an incredibly strong willed man with a very strong determination to heal.

It very much depends on the person, their job, their circumstances, their support etc.

Also pain relief is necessary to allow movement to help the body heal as movement is the key to healing.
When in pain we tense up and restrict ourselves.

Each to their own, same as childbirth some of us have epidurals some of us birth in a river.

I hope your husband gets the relief he needs. I second an osteopath if you can afford it and walking helps a lot too with back pain if tolerated.

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Hangingwithmygnomies · 11/10/2022 21:40

TheHateIsNotGood · 11/10/2022 21:25

For back pain, etc my first port of call has always been an Osteopath. I have done this for nearly 40 years and never resorted to prescribed medicine for what are mostly physical problems.

If you've got X-rays that explain the source of pain then maybe you need a Chiro, but I've never used one myself.

I'm not anti-medicine nor agin surgically invasive techniques at all - probably wouldn't be alive without them, but Osteopathy isn't 'quackery' and really should be considered.

Funnily enough, I have suggested this to him but he doesn't believe they can help him, especially because the medicals have told him nothing futher can be done and sadly we don't have copies of the xrays. I'd love to see a chiro and have a good cracking session!

@Daisydoodo so you mind if I ask what symptoms you experience? Of course absolutely fine if you'd rather not answer

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Cheeseandcrackers86 · 11/10/2022 21:41

I can 100% guarantee that the people on here basically stating that their GP should prescribe them basically any drug they ask for despite it being totally against the current evidence would be the first to absolutely destroy that same GP if a loved one just stopped breathing one night because of the cocktail of medication they're on.... or had a massive seizure and crashed their car..... or ended up in a coma with seratonin syndrome. It really doesn't matter what your beliefs are btw. No doctor is under any obligation to do something if there's a high risk of doing harm. That isn't being an uncaring or unprofessional doctor it's the absolute opposite

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SadHippy · 11/10/2022 21:44

OP, I know that people have commented on here who are real experts, so don't take my word for anything. However, I was on long-term medication before I had my hips replaced (amitriptyline, Diclofenac, gabapentin, pregabalin (when gabapentin made no difference), oramorph, and dihydrocodeine (this is a bad one). I said to the GP that I was concerned about the addiction element, and he said that people rarely become addicted if they are using them for pain relief rather than for any kind of 'nice' side effects. I came off the whole lot post-op and had no withdrawal symptoms at all. I was just bloody glad to be off them!

I would say that I am also very tough and have a massively high pain threshold, and there's nothing feeble about taking medication if it helps. If you have bone on bone arthritis, you don't have much choice (and even then, all the cocktail does is take the edge off your awareness of it very slightly).

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Butitsnotfunnyisititsserious · 11/10/2022 21:45

Therapy isn't going to stop his pain. OP it's not your choice what he takes for his pain, if it's doctor recommended, it's his decision. You don't have to cope with the pain all day long.

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Musti · 11/10/2022 21:45

Hangingwithmygnomies · 11/10/2022 21:40

Funnily enough, I have suggested this to him but he doesn't believe they can help him, especially because the medicals have told him nothing futher can be done and sadly we don't have copies of the xrays. I'd love to see a chiro and have a good cracking session!

@Daisydoodo so you mind if I ask what symptoms you experience? Of course absolutely fine if you'd rather not answer

I have found GPs tending to offer pain relief instead of treating the cause. I’ve just had surgery for something they suggested just taking pain relief for the rest of my life. I had to ask for a specialist referral, and I was looking into private.

A friend had to have private surgery after a c-section left her in agony as the nerves had knitted all wrong. She went from not being able to carry a bag and having to sit on a ring cushion to being able to lift weights heavier than her.

I don’t know anything about your husband’s condition but I would get a few different opinions from specialists, also look at acupuncture and other non drug methods of healing and pain relief. You lose nothing by researching and trying some other methods.

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ozymandiusking · 11/10/2022 21:46

It's the only thing that works for me. And lets face it, the medical profession can't cure everything, so they have to come up with something. Hence mindfullness, exercise, etc, etc. And yes, I am addicted, addicted to being painfree!!

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SadHippy · 11/10/2022 21:46

BTW, I also tried osteopathy (which I love, and which has sorted out loads of other problems for me, but which can't deal with bone on bone), acupuncture (not much effect) and chiropractic (huge waste of money). Physio was no good at all. Osteopathy would be my number 1 alternative therapy. I also have bulging discs in my spine and will go back to the osteo once my hips have recovered sufficiently.

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Daisydoodo · 11/10/2022 21:47

I slipped 2 discs in my back and neck following an accident 7 years ago. Tried multiple therapies, chiro, physio and none worked so have long term pain. I am also a professional and a mother of 3 (under 12’s). I guess the dependence has just snuck up on me so to speak I started on 2 a day that didn’t cut the pain so increased to 4 then 6 then 8. I never take over the maximum dose. If I run out or don’t have them for a day I get a debilitating headache, stomach pains and nausea and can’t focus on anything other then getting the tablets to ease the pain. Having discussed this with my GP during my annual medication review they told me i was experiencing these symptoms because I was dependent. I also take 25mg of amitriptyline per day too.

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TheHateIsNotGood · 11/10/2022 21:57

That's a shame hangingnomies - most Osteos charge around £40-£60 for the first session and less for the next 1-2. I've only come across 1 that sorted it in 1 session, and funnily enough she was one of the oddest, but one of the best.

However, Osteos don't cure forever but can ease the physical source for as long as years without any risk of reliance on pain-meds.

I'm quite poorish - but if my back goes I'll stick the cost on a credit card if I need to rather than resort to prescribed meds to numb the pain but not cure the source.

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JaceLancs · 11/10/2022 21:57

I have disc and shoulder problems - 10+ years ago I was offered acupuncture from my NHS physio department - sadly it stopped due to cost cuts - but I was a sceptic until it worked for me - since then I use a mixture of private physio at a hydrotherapy pool, acupuncture and osteopath
I can’t take any painkillers stronger than paracaetamol so don’t have many options

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Always4Brenner · 11/10/2022 22:01

I can get in hips a mattress topper has been invaluable but I do have codeine every so often, but try to use sparingly. Paracetamol foist times a day is my usual painkiller and ibuprofen gel.

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RosesAndHellebores · 11/10/2022 22:06

I have been prescribed cocodamol 30/500 twice. Both times for a fractured vertebrae. I have taken the full dose for about two weeks and have then titrated it down over the next day to the minimum I can manage on: 30/500 and a 15/50; 30/500 and a paracetamol; 15/500 and a paracetamol; 8/500 and a paracetamol. Regardless I have had awful diarrhoea for a few days as I stop taking it.

Naproxen works better imo.

Best of all is a good neurologist who conducts ab MRI and gives sound advice.
Mine recommended a good physio who provides tailored physio. She has also discussed surgery but my pain levels are manageable.

@Cheeseandcrackers86 do you honestly think good quality therapies are available on the NHS? My NHS GP refused a physio referral for me; refused a neurology referral and FFS refused to recommend a therapist for my 16 year old when CAMHS refused to support someone cutting and overdosing. I had find a consultant psychiatrist on my own.

I shall be very grateful if you will please explain to me how I am supposed to access evidence based optimal care on the NHS when my GP won't make a physio referral and has outsourced therapy to charities. DD contacted therapies directly recently and got referred to group therapy with about 15 others - the waiting list for 1:1 was too long even to put her it. Group therapy was rubbish by the way. What are your serious suggestions please?

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RosesAndHellebores · 11/10/2022 22:07

Apologies- tailored pilates not tailored physio.

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Hangingwithmygnomies · 11/10/2022 22:13

Butitsnotfunnyisititsserious · 11/10/2022 21:45

Therapy isn't going to stop his pain. OP it's not your choice what he takes for his pain, if it's doctor recommended, it's his decision. You don't have to cope with the pain all day long.

I never once said it was my decision whether he takes them or not - I asked if I was BU to be worried about him being prescribed these for long term pain and if you read all of my posts you'll see why, as I believed cocodamol should only be used short term from what pharmacists have told me about only using them for 3 days. I thought this was because of them being highly addictive but some kind PP's have explained what the 3 day rule actually is. You'll also read our friend became addicted and killed herself because of this pain killer which I don't think is an invalid reason to be on the more cautious side!

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ProbAmU · 11/10/2022 22:15

@TheHateIsNotGood I would love to see an osteopath but unfortunately I can't really afford it. Seriously been looking at whether I can manage a couple of sessions though, as I'm sure it would help

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rocketfromthecrypt · 11/10/2022 22:15

@Cheeseandcrackers86 I really hope you aren't actually a doctor. I have a condition causing chronic, incurable pain and no amount of chatting to a nice therapist or 'distraction' is going to help that. I need a cocktail of strong drugs (properly monitored) to keep mobile and make life worthwhile. You don't seem to have any empathy for people suffering from physical pain.

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Hangingwithmygnomies · 11/10/2022 22:21

TheHateIsNotGood · 11/10/2022 21:57

That's a shame hangingnomies - most Osteos charge around £40-£60 for the first session and less for the next 1-2. I've only come across 1 that sorted it in 1 session, and funnily enough she was one of the oddest, but one of the best.

However, Osteos don't cure forever but can ease the physical source for as long as years without any risk of reliance on pain-meds.

I'm quite poorish - but if my back goes I'll stick the cost on a credit card if I need to rather than resort to prescribed meds to numb the pain but not cure the source.

I'll see if I can perseude him to at least have a consultation with an Osteo. What's the worst that can happen - they say they can't help and he stays in the same amount of pain as he is now? I could probably benefit from seeing one myself anyway due to some risidual issues from SPD in pregnancy

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moonypadfootprongs · 11/10/2022 22:22

Cheeseandcrackers86 · 11/10/2022 21:41

I can 100% guarantee that the people on here basically stating that their GP should prescribe them basically any drug they ask for despite it being totally against the current evidence would be the first to absolutely destroy that same GP if a loved one just stopped breathing one night because of the cocktail of medication they're on.... or had a massive seizure and crashed their car..... or ended up in a coma with seratonin syndrome. It really doesn't matter what your beliefs are btw. No doctor is under any obligation to do something if there's a high risk of doing harm. That isn't being an uncaring or unprofessional doctor it's the absolute opposite

Leaving people in agonising pain is not being caring or professional. Thank god your not my GP. In fact I doubt your anyones GP @Cheeseandcrackers86

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moonypadfootprongs · 11/10/2022 22:26

@Hangingwithmygnomies I have been prescribed oramorph for over 3 years for gynaecological issues. I take it when I need it. Some periods I have taken it multiple times a day for moths at a time. Others it's a couple of nights I need it. I have never had an issue stopping it. Never had withdrawals, never have craved it etc.
So it is absolutely possible that he wouldn't become dependent on it. Despite all the negative things said about it.

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Dou8hnuts · 11/10/2022 22:34

I suffer chronic pain and am prescribed co-codamol. My pain and condition fluctuate so some days I may need 2/3 doses and other days just one or none. I’m not addicted, I’m also prescribed an SSRI because my condition also exacerbates symptoms of depression. I’ve never felt like I need to take the meds religiously even though my GP said I can take up to 4 doses in 24 hours. But should my pain be so bad I would have the option to do so. I’ve managed pretty well sing w having cocodamol over drugs such as amitriptyline, gabapentin and pregablin. Pain relief such as nefopam and tramadol left me feeling too spaced out. Regular checks with a doctor are key when on any long term medication. I recently had a really tough week and I could feel my grip on my emotions faltering. I upped my dose of my SSRI and at my next opportunity I let my GP know, I’ve been on them 7 years now and when I feel
calmer I will drop them down again to the previous dose.

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Cheeseandcrackers86 · 11/10/2022 22:36

rocketfromthecrypt · 11/10/2022 22:15

@Cheeseandcrackers86 I really hope you aren't actually a doctor. I have a condition causing chronic, incurable pain and no amount of chatting to a nice therapist or 'distraction' is going to help that. I need a cocktail of strong drugs (properly monitored) to keep mobile and make life worthwhile. You don't seem to have any empathy for people suffering from physical pain.

Why do you assume that somebody who wants to do what is right for you rather than what you want lacks empathy? Of course no doctor wants you to be in pain but the truth is that pain medication just doesn't work for chronic pain. Where is the line drawn when the painkillers just aren't cutting it? How much risk of death or serious side effects are you willing to take? How much risk should a professional take when a bad outcome could easily destroy them? To be really honest lazily labelling somebody as 'lacking empathy' because they are being pragmatic and telling you a truth you don't want to hear is emotionally manipulative and completely lacking empathy towards the professional who is ultimately responsible for anything that might go wrong.

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