To be a bit concerned about what the lady at the pharmacy said

[Lalalalas]

So My friend recommended co-codamol for period pains, since have had my coil put in, my periods have become so much more painful. I asked the lady behind the counter if they were good and she said "I don't know, I wouldn't take them if you paid me". What was the reason for this? now I dont know if I should take them.

I take them a couple of days a month for period pain - I don't actually find them hugely effective but slightly better than paracetamol! I'm not addicted and generally think addiction is at a larger risk when you're having to take longer-term for constant pain relief.

I took 20 mg codeine for about 3 weeks after I had my lower wisdom tooth taken out ( not routine tooth split into bits and he had to use drill to get root out!). When I stopped taking them I didn't feel anything and didn't feel like I needed them again. I do understand everyone is different though.

Another who used to work in pharmacy and wouldn't touch co-codamol. A lot of pharmacy staff are not happy about it being sold OTC as we see the same people come in week after week asking for it, and then asking in nearby pharmacies if refused. It is only meant to be sold in pharmacies for short term usage, due to the addictive nature. If people require it for long term pain relief then they are meant to get it on prescription from their doctor.

I wouldn't use it tbh. I don't think it is noticeably better than just paracetamol and I think it is ridiculous that codeine is sold OTC (even in small amounts).

Urgh. I love co-codermol. Its why I dont take them unless its an emergency.

There are much better alternatives for period pain. Finding the right pain relief for the type of pain you are experiencing is more effective than just increasing the strength of the pain killer.

It's been mentioned a couple of times on this thread but Naproxen is a much better analgesic for period pain, it's not addictive. It's available over the counter at Boots.

www.boots.com/boots-period-pain-reliever-250mg-naproxen-9-gastro-resistant-tablets-10307099

I wouldn’t take them and would try and get the copper coil changed to a mirena. I loved my mirena coil and didn’t have any periods at all for over 10 years with it.

I take co codamol occasionally but I don't have an addictive personality.
My dm takes them regularly and she's fine.
Alcohol is just as dangerous.

Very unprofessional, she should have directed you to the pharmacist (I assume she was not qualified). Maybe she has had a bad experience with them? I’ve only taken them a few times but often been sick after so they wouldn’t be my first choice. Haven’t taken them enough to be sure being sick was a correlation with the medicine though.

Because they're effective painkillers. But yes - they're highly addictive. That's why you're only allowed to buy small amounts at a time.

I worked in a pharmacy briefly after I left university, it was extremely eye opening in many ways.
We had a lady come in every single day (we had daily stock deliveries), to buy the one bottle of cocodamol that got delivered to replace the one she bought each day.
Eventually I asked the pharmacist about it, as I had to get her approval for the sale each time and she basically told me that the lady was addicted and it's the strongest thing you can get over the counter.
Once the delivery didn't come and she came back the next day and asked for both the bottles that had been delivered but they can only be sold one at a time.
Eventually I realised that I could control the stock management and choose to stop the redelivery of that sold item.
She stopped coming after about 3 days of it being out of stock and I never saw her again.
I think the pharmacist was being a bit negligent allowing the lady to buy it every day and I imagine she just went to a different pharmacy to try and purchase it instead.
It was really sad, she looked like a drug addict honestly.
Interestingly there was a special locked cabinet for the drugs that were prescribed to recovering drug addicts to help them gradually wean off strong illegal drugs. We only had a few of those though as it was a very small town.

The thing you absolutely MUST NOT do is take more than eight co-codamol a day, and if you do take eight in one day you MUST NOT take any other tablets containing paracetamol that day. The short term risks from excessive amounts of paracetamol are much greater than from the codeine.

It needed saying. The person mentioned in the thread taking thirty tablets a day was taking plain (presumably prescribed) codeine, not co-cocodamol.

I'll just add that a year or so ago, I was still on one Diazepam a day "as necessary" (after losing my husband.) It was the smallest possible dose - 2 mg I think?

I had bad toothache, so had taken a co-codamol. Had tried paracetamol and ibuprofen, but had got no relief.

My dentist asked what I'd taken for pain relief. Told him 'Co-codamol.' He looked at me as though I were a junkie: 'Why do you need something so strong?'

Maybe he queried it because my record showed that I was on Diazepam and had been on Zoplicone (smallest dose again).

I should have told him that I hadn't deliberately been widowed during lockdown with no access to bereavement counselling, but I'm afraid that I just bit my tongue and felt ashamed.

Anti inflammatories are better for period pain, if your stomach can take them. Just take some basic ones with food, and if its worse, see your GP. Better than codeine, I got constipated when taking them, then when coming off them, I had the opposite effect lol.

Presumably she is a pharmacist or qualified appropriately so if she said that she’s got good reason for saying so.

I wouldn’t have been offended by her comment but I prefer straight up people.

Did she really not explain her comment or do you think because you got het up you forgot? Because they always explain they’re addictive when I get them.

So if pharmacists comment was “please be aware these are addictive…” then later in the convo “you couldn’t pay me to take them.” I really don’t think that’s that bad.

Understand you have OCD though OP and how hard that must be.

The dose needs to be titrated up to avoid this. It may have been a stronger dose than you really required - or perhaps a different type of analgesic would have been better as they work in different ways.

Oh good point. Yes, the constipation is another reason that I avoid them.

I took them for years for migraines. They were the only thing that stopped it in its tracks. However I probably only took four tablets (at most) a month as my migraines were linked to my hormones.

I've used co-codamol twice in my life- once after a dog bite and once following an eye injury. Both times prescribed - both times I really needed it.

However, poor DD has had ferocious period pains and co-codamol was the only thing that could touch the edges until the GP managed to sort out another solution. The advice was never to use for more than 2 days because it's addictive but they did at least mean she could sleep and walk about without crying when it was at it's worst.

It can leave you feeling a bit spaced out so not one to use when driving for example but for period pains used sparingly I would recommend it.

Incorrect - there are different doses of co-codamol and only the lowest codeine dose is OTC - the rest need a prescription.

The word “addictive” is misleading and not used in official literature - potential for abuse and dependency are the terms used.

Abuse occurs if people use them in a way that’s not indicated ie people without pain who use them to get high etc. or deliberately take more than the prescribed dose.

Dependency is more nuanced - people may become dependent if they are very fearful of the pain coming back for example, people with advanced cancer.

They may be on morphine for example but then get a treatment such as radiotherapy which reduces the tumour/pain burden (tumour no longer pressing on surrounding structures) so their morphine dose could be reduced but they are afraid to take the reduced dose as they are terrified of the pain coming back. They may also like the spaced out feeling that comes with taking a higher dose than technically necessary as it buffers against the constant thinking about dying.

I’ve seen both these situations many times over my working life. Pain management is grossly misunderstood - even by non pain specialist consultants.

If you need advice on which is the best pain killer to take it would be a good idea to head in and have a chat with a pharmacist about what would be best as they can answer all your questions.

Codeine is an opioid and can be addictive. There are a lot of people who take codeine 4 x a day every day for legitimate pain and would have withdrawal symptoms if they were to stop, even though they are 100% taking it legitimately as they have been prescribed. I have probably seen on 2 occasions over the past 18 years in healthcare someone who has become addicted to over the counter codeine and required an opiate withdrawal program to come off it (such as methadone), its really not that common although it is a known risk.

That being said it is a good pain killer for moderate pain along with a non opioid painkiller such as paracetamol especially for short term use (e.g. Postpartum, toothache). Prior to you asking your friend for advice I'm assuming you were experiencing pain that wasn't being managed with simple analgesia such as paracetamol?

NSAIDS (ibuprofen, naproxen) can potentially work better for period pain due to the way that they work however they aren't tolerated by everyone. These can also be taken along side paracetamol. On top of this you can use hot water bottles or a TENs machine to help and antispasmodic medications like buscopan can be really helpful. There are other options if you would prefer to avoid opioids.

I had codeine at the hospital for after an operation last Friday. I was very constipated.

I take them for period related migraines, I just make sure I only take them for the worst days.

Are you taking regular Paracetamol and Ibuprofen (assuming you can take both) when you get your period by regular I mean 1g of Paracetamol 6 hours, 400mg of Ibuprofen 6-8 hourly.

Taking these is known to reduce/ remove the need to escalate to a stronger opiate based painkiller.

Codeine is a weak opiate.

As a registered medical practitioner with expertise in pain management I would always suggest doing this before escalating to opiates.

Some people avoid opiates due to risk of addiction (which is pretty small), others because they don't like the side effects.

I personally don't like taking codeine as it makes me really woozy/ dissociated and I don't like it therefore I only ever really take it if I'm going to be asleep while it works. I wouldn't however say this without context to a patient.

I'm another who can't take even the lowest dose of codeine as it makes me violently sick. I had it prescribed in pregnancy, so it can't be THAT bad as a drug - although clearly it's not for me.