To be worried about Codeine

[TherealKimK]

So I am waiting for an appointment at my GP as my lower back is really playing up at the minute, I dunno if this is part of getting older (im 33). I went to the pharmacy and they gave me some co-codamol which has really helped along with Ibuprofen, I do have quite an addictive personality and the pharmacist did warn me these things could be addictive, I have been taking them for longer than 3 days (only the recommended dosage and would never increase as I am too scared)

Should I worry about this? does anybody else take codeine?

No you aren’t over thinking it. There is an huge issue with over the counter codeine addiction in the UK.

I would try gentle back exercise and check your posture. I don't like or use meds if I can help it

I was on the 30/500 dose for a period of 9 months or so and was definitely worried about addiction but I was dependent on them for pain relief and only once ( at start of taking them) do I ever remember a cosy/ all is well with the world feeling so maybe I don’t metabolise them in same way as others. I reduced them as my need for pain relief decreased and was fine. It does fascinate me how vastly different we are all with medication - once during the spinal injury I had I was in so much pain I wanted my leg cut off, nerve pain was so bad I would had cut it off myself if I could have- was in the hospital nearly delirious with pain and they gave me the “ strongest” dose possible of morphine and genuinely I felt nothing no relief, The doctor told me he gave the woman beside me half the dose I was one and she was felt off her face and flat out sound asleep .
Think I must have high threshold for opioids .
To answer your question, just be mindful of your doses, avoid long term used and taper off slowly if required!

I feel duty bound to tell you not to go crazy with exercises or seeing osteopaths, chiropractors and the like, either until the pain subsides or you have had an MRI. I waited well over a year for an MRI (2013) and when I saw the results I was horrified. Horrified that I had let an osteopath literally yank me all over the place, prior to and in the 12 months leading up to my MRI scan. I should have waited, please be very careful.

I took loads of codiene after a nasty break. Also when I was ill and had migraines. I did question it as I have an addictive personality but it was fine. Pain stopped and so I stopped with the painkillers.

I don’t think they made me feel good though possibly a bit down and a bit emotional.

I take them regularly. Not all the time though. I have a hip condition which flares up and I need codeine to deal with it. I can go months without it and then need a couple of weeks on them .

One thing I've noticed though is that paracetamol on its own isn't very effective any more.

I asked one of my specialists about addiction to codeine and he said that when you take it for severe pain it's not too addictive.

8mg is a tiny dose, you are highly unlikely to come to any harm beyond mild constipation. I've been taking the 30mg tablets for more than 15 years to keep my arthrititis down to a dull roar. I am allowed maximum of 8 tablets a day, I have 2 at bedtime pretty much every day, some days I have to take them through the day, some days I have none. Other than constipation, I have no side effects at all. The side effects of paracetamol and brufen are pretty grim too

I was prescribed codeine at the end of last year and took it on and off for a couple of weeks - not everyday, I had good days and bad days pain wise.
No addiction issues.

I had this! Took them once for tooth pain and as I floated up on a cloud of bliss thought 'hmm, better not take this again!' But my friend who takes it for back pain can stop and start no issues. That's interesting that we metabolise it differently.

I'm no medic, but have noticed that when one is in a lot of pain, one's threshold for morphine goes up, it all seems to go into the pain.
Other drugs they may be on may cause them to need less/more as well..it's an art getting it titrated right so the patient is comfortable but not over sedated.

My elderly neighbour was found grey and in pain after breaking her leg- medics gave her a Morphine injection and to see the colour flow back into her face within minutes and her eyes to sparkle was surprising.
She looked less pinched with pain, bless her.

Tolerance also develops quickly, which is why there are so many 'strengths' of Morphine and other opiates/oids out there.

Some people like my friend are ''poor responders'' to morphine, and get hallucinations from it.

What astounds me is how we have receptors in our brains and bodies that fit the molecules from a plant. {Papaver somniferum}

@oakleaffy that’s interesting I definitely would have taken the Euphoria feeling for sure but felt like it just barely touched the pain levels, what helped me was a very high dose of amitriptyline , double what I was on but was a miracle worker even though I felt zonked and fell asleep so often until I got used to it! I really feel for those who are addicted to any medication as during my 6-9 mths of pain and codeine usage I felt panicked that I would run out , wouldn’t get another prescription etc.but that was due to the pain relief nothing else. interesting the times I’ve been prescribed diazepam for back spasms Again did very little but possible dosages too low.
gas and air was a good distraction for me though and I could have happily stayed on that and floated on clouds!

@Dontwakeme I’d guess you had/ have neurological pain.
Amytriptylene does help with that. ( had it too)
It’s a really Oldskool antidepressant as well.

Opioids alone aren’t that great at nerve pain ( so pain specialist said at hospital.

Referred pain is a strange thing
I felt like I had a broken ankle from sciatica!

I must be the exception. I've used these for years on and off for severe back pain and can just stop them without any withdrawal symptoms for weeks at a time if necessary. As soon as the pain subsided I just stop using them.

Go and see a chiropractor. Its far more effective.

I have been lurking on the addiction threads on here. Most of them are taking way above the recommended dosage, Some even 60 plus tablets...per DAY! I suppose even if I am addicted, my withdrawals shouldn't be too bad at this point. I like to see myself as quite a sensible person and I am glad I addressed this before being in a worse position, thanking my anxiety for this one

Hope you’re starting to feel better. Good you’re aware re the addictive properties, but if it sorts the pain - great, and perhaps your prescription is short-term.

Either way, being on long-term pain relief isn’t necessarily the same as having an addiction problem. Think use vs abuse.

That's the thing, I was struggling bending down for the kids etc so it has massively improved my pain.

So basically addicts take copious amounts of the stuff?

Yes, addicts’ tolerance to certain drugs/alcohol increases over time, so higher doses are required to achieve the same effect.

But I didn’t want to stigmatize people who are necessarily on long-term pain relief, managed via a GP/hospital (altho sometimes people remain on meds long after an underlying issue has been sorted, and really struggle to come off - so, in effect they have to deal with withdrawal problems like addicts who are cleaning up).

Same here. I would be more concerned about the possibility of becoming constipated as a side effect than becoming addicted.

I have what's considered a very poor conversion rate for codeine - so even large doses have very little effect on my mood and pain relief. I understand that 10% of the population is like me. And then there's the super converters and they are very effective at converting codeine to morphine and they are the ones who need to be careful (and the reason why kids should not be given codeine) as they will get a lovely buzz from very little. If you are getting a lovely buzz, I'd be worried.

How interesting.

I’m probably coming from a place of heroin cessation, which is obvs much stronger than Codeine. That said, I’d be surprised if the neurotransmitters were functioning sweet and dandy after a week+ off long-term Codeine use at a high dose.

A friend has that conversion rate issue too. One size does not fit all etc.

Hope you’re taking care re your back when lifting the kids, OP ✨

I googled this..

"The hepatic CYP2D6 enzyme metabolizes a quarter of all prescribed drugs, including codeine. The CYP2D6 enzyme converts codeine into its active metabolite, morphine, which provides its analgesic effect. Consequently, pain relief may be inadequate in individuals who have 2 inactive copies of CYP2D6 (“poor metabolizers”, PMs), because of reduced morphine levels."

Seems ultra rapid metabolisers {converters} can overdose very easily on even therapeutic doses of codeine, poor metabolisers may not get a therapeutic effect from codeine.

Ah this is interesting. I recently had surgery and was given codeine and tramadol, they seems to have no effect on me whatsoever - either for pain relief or for giving me any kind of pleasant cosy feeling that people describe. They literally did nothing.

I saw a thread on here recently about tramadol and people saying you would be off your nut on it but it honestly did nothing for me. I stopped taking both and actually got more pain relief from paracetamol.

On the flip side I have a friend who got addicted to codeine quite easily, so it must just affect other people differently as you say.

Codeine Withdrawal is so mild that many people don't even realise what it IS.

They may just feel slightly down, and have aching legs and a bit of a runny nose , headache and trouble sleeping, and not even attribute it to codeine cessation.

My friend was suffering what looked like codeine withdrawals... I mentioned it to him, and he took some of his prescribed codeine, and felt better within a short time.

His GP gave him a reducing prescription for codeine and advised him to come off them slowly.

For me the line for addiction is when need over takes want.

You might want to take the codeine for the pain relief problems start to arrive when you absolutely need to take it regardless of the consequences

I can have a problem with alcohol. There are times when I want a drink. A single cold glass of something specific with friends. Fine I'll have that drink. When every cell in my body is screaming out for a drink any drink at 11 o'clock on a Mon morning. I NEED a drink. I know it's a bad idea because I am at work and I have a meeting later and so on but I desperately NEED to find that drink. On those occasions I do something else and check in with myself about why those urges have occurred. I talk myself down and address why there was such a strong need for destruction/obligation/harm/whatever. It has taken time but I now no longer drink when I feel the need to drink.