How do I tell the gp the mess I'm in

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I'm hugely dependent on codeine, it is prescribed but I take way over what I'm meant to 500-600mg daily which means I run out early every time. This means I can't taper done properly because I run out then have to buy otc and then it starts again. My husband has forced me to call the gp and tell them, I'm just waiting for them to call. I'm terrified though. Terrified they're going to call ss on me. I'm a normal person, I'm not a druggie on the streets, I'm not a scumbag, I'm a young mother of 3 kids who are my whole life.
I have my own home, job, husband etc but I am addicted to codeine through being prescribed them years ago for back pain which was never investigated. I now know that back issue is a herniated disc and it causes sciatica. I can't stop taking them as I get horrible withdrawal symptoms and I can't function. Please help me I don't know what I'm meant to do

So I just rang the keyworker and stated all my concerns, which I think are valid, especially after speaking to people who have been through it and even someone who works for a drug clinic.
I was told that basically what you guys are saying isn't true, I need to be In withdrawal for 24-36 hours (i thought that was methadone)
That I can speak to management and the prescriber but they will tell me the same thing, that the plan had been made and I basically need to deal with it.

Believe it or not I do have my head screwed on and I stated I know something isn't adding up here. They are withholding a treatment that is going to be in my best interests. I am high risk for overdose (I have already had an accidental overdose of otc cocodamol last year which I was treated in hospital for) surely that would make me high risk ?
I have said I am an addict and I cannot control my usage. She didn't give a shit basically, kept talking over me, she just didn't listen.

I am now going to call the gp and state the same reasons why I can't do a started withdrawal. Someone had to help me in the way that is going to work for me, they have a duty of care and I'm being fobbed off here I know I am.

Oh I also said so are you telling me when I'm on only otc codeine you will prescribe me, she said yes, then I said so I could be taking about 200mg of codeine a day (which would be the maximum considering the paracetamol and ibuprofen daily dosages) and you'd then be happy to put me on a substance which is 50 times stronger than morphine to get me off it ? Does that make any sense? Suddenly she was saying oh no well there is no guarantee you'd be prescribed. I know now for a fact I'm being bullshitted I just don't know why.

Honestly, I can’t believe what I’m reading. Why are they so reluctant to help you? When she said you can speak to a manager but they’ll tell you the same, I’d have said “Yes please are they available now?” When you call the clinic, is it the same woman that giving you this information each time? They absolutely do have a duty of care and they are completely failing you. Mate, I’d be writing to my MP. Furious. They can’t fob you off like this. This is literally what they’re there for.

She's just rang back and I've got an appointment with the prescriber on Friday "so she can tell me why it's so dangerous" just don't understand it I really don't !!!

So I'm Gona need some advice for this !!
Why is it dangerous ? They're adamant I have to withdraw for 24-36 hours but everything else states mild withdrawal or early withdrawal and of course posters on here who've actually done it state the same too.
I could take my last dose of codeine at 8pm and by 10/11am I'd be in early stages of withdrawal

I do that some days anyway !

It certainly sounds like they could help you better

Keyworker keeps saying we don't deal with codeine it's heroin etc and things like that, I think it's because they think I'm not injecting street drugs then I'm not that bad enough to need it or something. When in reality They have no clue how much I'm struggling with it. 700mg is such a high amount to take so I don't see why it should be any different. An opiate is an opiate at the end of the day, mild or strong, they're all addictive.
It would be safer for me to be taking buprenorphine than it is codeine at my amounts !

It's very high, I take codeine sometimes and more than 150 mg would make me vomit

Tolerance varies all the time like the weather-
There really isn’t an upper level - as one neuroadapts, tolerance grows as body gets used to it.

However-
Detox ( and plenty of people in bad old days had to do heroin detoxes in jail with just paracetamol if lucky ( These were often people with high tolerance- but it resets to zero after a few days abstinence.

People on methadone need to wait much longer before transfer and do have to be in withdrawal- the worse the withdrawals the better because of the action of Bupe ( partial agonist)

Another odd thind with Bupe people are rarely given any more than 32 ( Thirty two) milligrams a day because of the “ Ceiling effect”

More doesn’t mean more effective.

@oakleaffy Can I ask, am I taking too high of a dose to be switched onto bupe? That's another thing that was said which I don't understand to be true.

I've read today that the last codeine dose needs to be at least 6 hours before you start bupe, so no idea what they're on about.

OP the guidance is that bupe is predicted to increase the risk of opiate withdrawal when given with Codeine, so presumably the reason they want you clear of it is to reduce this risk.

Hi @Mrsttcno1 thanks. Could you send me some info please ?

It wouldn't be given with it though, I'd have to be in early stages of withdrawal which would be easily done by having the last dose on an evening and having first dose of bupe around lunch time the next day

This info is on a work page so I can’t link it but if you google both medications together you should be able to see the same info there and the risks of mixing/overlap. I’d recommend going back to GP and even asking for an appointment to talk this through, take someone with you if you can. My uncle did this and got a proper plan, lots of support, and a taper plan put in place. It’s never going to be pleasant or easy though, and there isn’t a simple way to get off these things, if there was everybody would do it. You can do it OP. Good luck x

Thank you. I am speaking with the gp Friday so will go from there.

To be honest I keep going between wanting to start the bupe but then not... I'm torn.
I'd like to think I can taper even if it's by a tablet every two weeks. It's more the otc I don't like having to take because I know it's got other stuff in it. I need to know what the reaction plan is before I go any further, I haven't even been told that.

It doesn't seem to make sense at all
I take 240mg codeine daily for back pain and can stop/start so I don't need to taper so if you get down to a smaller amount then well, you wouldn't need the other drug?

Exactly. They're just bullshitting me, that's quite clear now because when it's put that way then it's pretty clear they wouldn't put you on an extremely strong opioid to taper off that amount of codeine.
I just wish they'd be like look we won't prescribe it for codeine, we only prescribe it for heroin, I'd be like okay that's fine. Why give me all these weird excuses

The typical guidance for taper I believe is a 10% reduction in total daily dose every 1-2 weeks, it can be slower than that if needed but again that’s something you and your GP can discuss to make a plan x

So I'd have to drop 70mg every 2 weeks ? That's huge for me

It’s a plan you make with your GP, it doesn’t have to be exactly that you can speak with them and come up with a plan together to get you off these for good.

As I say OP, I was taking between 25/30 30mg codeine every night (all in one hit) my tolerance was so high. I was always chasing that first high I got with codeine. The GP saw me before the clinic and they agreed to keep prescribing the dose I was on. They didn’t want to interfere with my dosage. Then I was transferred over to the medical clinic (I’m in Worcestershire so mine was Cranstoun) I was told to have my last dose of codeine on that same night, then wait until the next day (around the same time I would usually take them) and start the bupe. I haven’t looked back since. In fact, my mum gets prescribed them now and gives me boxes of them to give to my neighbour. They sit in my car for days and I have absolutely no urge. It’s incredible. Fight for the bupe. Tapering off codeine is so risky. I know I wouldn’t have been able to control my dosage. 💕

I know I’m probably stating the obvious here, but have you searched google or asked GP if there any other drug help centres in your area? X

OP, this was my experience too.

That's huge and all in one go too ! You're proof that people like me can be helped, well don't btw, you've come so far !! You guys really give me hope ❤️

They haven't even given me enough tankers to cover tomorrow until I get s phonecall off the pharmacist, just ridiculous. She could call me at anytime up to 6.30pm, do they not think about withdrawals ?

I am in Staffordshire so am using Stars. Have I got a right to ask for a different keyworker? I think I've got off to a bad start with my current one and feel like she hasn't any compassion to my situation, maybe she has become desensitised I don't know but I don't feel we'll be a good mix after this rocky beginning.

I do think they don't want to give me Bupe because I'm not taking street drugs, I can understand wanting to avoid it if possible and I will be fine with that as long as the reduction is slow. The thing is I haven't even been told the reduction plan, no one has thought to involve me. The keyworker stated how the plan has been made, but yet nobody has asked me my thoughts on this plan.