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

[pleasedontjudgemeidontneedit]

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

Methadone sounds awful.

I just want to say thank you to everyone on here who has supported me the last few days, honestly if I didn't make this thread I don't know if I would've had the courage to do what I've done today. So from the bottom of my heart, thank you.

I will keep updating if that's okay, it's easy to talk to strangers, it's somewhere to write down my emotions and also hopefully can help others going through the same.

Hopefully it won't take too long for the service to get in touch.

So glad you’ve had some positive progress OP. As others have said Methadone is used more for heroin addiction, it acts in the same way and would have a full opioid effect. Subutex is a type of Buprenorphine which is what’s called a partial agonist - you won’t have the sedative effects of Methadone, and you’ll be able to think much clearer. Also the risk of overdose is very low with Buprenorphine as it won’t effect your breathing in the same way Methadone does.

this is a good link which explains how it works: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/buprenorphine#:~:text=Buprenorphine%2Fnaloxone%20is%20a%20pill,special%20training%20can%20prescribe%20methadone.

I just wanted to suggest asking about Buvidal if you are going to commence into medication. It's buprenorphine (the drug in subtex/espranor) but in injection form. You'd just go into service once a month for your injection no having to go the chemist etc. It's a game changer. It's expensive though so I'm not sure every service offers it yet. My service is huge so was a pilot for buvidal and it's been that successful we now have a buvidal team. Just another potential option. Good luck

Is it true that buprenorphine causes tooth decay ? Just been doing a little research and this comes up.
And would I likely be stuck on this drug ? Not that it matters as it's better that than codeine but just trying to get educated

It is taken ( in U.K.) as a sublingual tablet.
which goes under the tongue and cannot be swallowed ( It is in effective that way)

Taken for a short time it’s unlikely to cause dental issues.

It varies as to the individual
Some people have wonderful teeth after decades of Methadone and Taryak , others have no teeth.

Washing mouth out with water half an hour afterwards might help.

Generic Buprenorphine is what’s usually offered on NHS, Subutex is the brand name and much more expensive- and can have supply issues.

It’s not something I’ve really heard of happening, but would be worth asking. As PP mentioned, Buvidal injections are an amazing option if your service offer that.
You wouldn’t necessarily be stuck on it no, they would get you on an optimal dose to ensure you are comfortable, and then you would be able to look at some options on reducing down or a detox

Hi op, I know people will roll their eyes at this but thought I’d mention on off chance it does help you. You’ve mentioned a few things that remind me of adhd - addiction prone/low will power, intrusive thoughts/ocd, anxiety, loud thoughts (possibly), but alsoanti depressants working for you - common in adhd from what I hear.

anyway sorry might be totally off the mark.

they would get you on an optimal dose to ensure you are comfortable, and then you would be able to look at some options on reducing down or a detox.

Op, Buprenorphine and other medicine have been mentioned to deal with withdrawal symptons which is obviously a good idea.
However physical withdrawals don’t last that long and it’s the mental cravings that continue for longer.
Therefore I would really recommend going to NA meetings on a regular basis as they will help keep the cravings away and you will find help and support from people who are going through/have been through the same as yourself.

Hi everyone

So I still hadn't heard from the drug service, I rang this morning and they said someone will be in touch either today or tomorrow. I hope it's today, I'm struggling with my anxiety so badly. I really do think the codeine is making my mental health worse.

I am also about to run out aswell so not sure what I will do as the gp won't prescribe more because it's too early to refill my prescription. I can't do it until Friday and then it won't get approved until after the weekend. Hate being in this endless cycle.

OP, I missed whether you spoke to your GP about it? Or did you just go straight to the source? If your GP knows, they prescribe you what you need until the relevant help is available. It can be dangerous for you to not have them if you run out and they’re aware of this. You could book an emergency appointment and see what they can do to help.
I know the cycle. It’s horrible. X

Do you think I could call the gp today and explain the situation so I am able to have some tablets until they get in touch ? I just went straight to the clinic.
They are meant to be getting in touch today but I'm guessing I will still then have to wait for an appointment. I've got 5 tablets left so that leaves me with only otc which I'm obviously limited to what I can take

Also does anyone know if the clinic will make me go cold turkey from the dose I already take in order to start the buprenorphine or will they taper me down to a lower dosage first?
Really don't like the idea of withdrawing for 24 hours off the high dose

It sounds like by the time you get an appointment you will already be on a lower dose. Unless they see you today, which you could push for

Call and ask for emergency appointment today. Explain and be open and honest with your doctor. They should give you a prescription to see you through till your appointment.
When you get your first appointment with the clinic, they will explain your options and I’m pretty sure you get started straight away to avoid withdrawals etc:
Good luck OP. You can do this 💕

Thank you, yes I am going to call the gp as they're going to be told anyway by the clinic so no point me trying to hold anything back now.

And I've read online that you need to have no codeine in your system before you start the buprenorphine and it's that what worries me because of the withdrawals

So regarding when you are to take your first buprenorphine - they ask you stop taking codeine and wait until you start to feel the withdrawals (depending on when and how much you take this can differ person to person) As soon as you start to feel the withdrawal (a matter of hours usually) then you start the buprenorphine. Withdrawals will subside immediately. X

Normally when a client is started on buprenorphine yes they would have to have the opioid out of the their system. If you have the opioid in your system and then take buprenorphine it would cause precipitated withdrawal - https://americanaddictioncenters.org/suboxone/precipitated-withdrawal#
This is because the Buprenorphine will kick the opioid out of the receptors, causing a harsher withdrawal. It will be a bit of short term pain, long term gain (but try not to let it scare you, you should only need to be in a mild withdrawal). Try not to let it put you off, it’s either this or carry on as you are which is obviously not sustainable for you. I hope you can get seen soon :)

Thank you.

Do you think they would make me go cold turkey from a dose of 600-700mg daily? As this seems dangerous really. And will I have to go to a pharmacy and take the medication ?
Still waiting on a call back from both the gp and the clinic 😐😐

That isn't the case at all {about no codeine in system before buprenorphine}
People transfer to buprenorphine from methadone and fentanyl , but there has to be a 'gap' between last dose of drug you have been taking and first tiny dose of buprenorphine.

Someone taking a 'full' dose of buprenorphine even with a time gap will be plummeted into precipitated withdrawal that just has to be ridden out.

Transferring is going to be uncomfortable, no matter what.

Ideally a proper drugs service is what you need to get the timings /dosages of buprenorphine right.

They will probably know about codeine timings. Codeine is very short acting, so that is in your favour!

Be very honest with the drugs services about the amount of codeine taken, so they can get the 'best' dose of buprenorphine for you.

As PP said, there has to be a bit of a gap, but the prescriber will advise how much and the dosage will converted to match the dose of codeine you take. I haven’t had much experience of codeine yet (I’m relatively new in my service) so I can’t advise how long it would be, but as an example when changing from Methadone to Buprenorphine, the client has to take their last dose on the Sunday and then starts Buprenorphine on the Monday.
Yes, you would collect this from a pharmacy :)

@Jklow1254 Thank you for the information about this. Would I always have to collect from a pharmacy ?

I've spoken to both the gp now and the clinic afterwards. I told the gp everyone, they were fine about it, said it is quite common and not to put to much pressure on myself about how I've ended up where I am. They were a little shocked by the amount I've been taking which I get, and I explained this is how I know I need help and want to stop, because it's gotten out of control.
They've taken it off my repeat prescription and given me enough to have 15 tablets a day, although thats only going to last me until Friday. Then I spoke to the clinic who said i'm looking at a good couple of weeks until I'll be assessed and prescribed, so that I need to call back the gp tomorrow and explain that I need enough codeine to keep me going until that point.

Do you think the gp will do this ??

It’s entirely dependent on the GP but for addiction they much prefer to leave prescribing to a drugs service ( and for good reasons)
Once a patient is labelled an addict GP’s are naturally fairly concerned about irresponsible prescribing so prefer “ Shared Care” with a drugs service.
The drugs services are usually staffed by people who understand addiction.
Supervised Consumption is the norm now for new people- keeps everyone much safer, especially with children in the household.

Even people who get weekly “take homes” have earned that right by being safe and even if they have adult children, they are asked about where the meds are kept, and if anyone ( human or animal) can access them.

An injection stops need for daily pickup but these aren’t available in every area. ( Expensive)

Apologies if I’ve missed this bit but What about the origin of your pain OP? Have you had an MRI to see what the problems are as if you do withdraw that will be fabulous but if the cause of your problems remain you still need some kind of treatment

Normally clients can be set up for weekly pick ups if they are not high risk, so you would pick up enough for a week. They can also arrange holiday scripts, so if you go away they can arrange for you to have enough while you are away. Rules will be different in different services though so don’t quote me on this!
Yes the GP will have a duty of care and will have to help you!