What’s the deal with codeine? Why all the questions? Read on to find out!
New regulations regarding over the counter products containing codeine (codeine phosphate hemihydrate) were brought in to help add an extra step of control to the supply of these products in Ireland and to make sure that if they are being used, they are not used as first line treatment (ie not the first thing you try for a headache or other pain) and that they are used for the right purpose.
WHAT ARE THE PRODUCTS?
In Ireland, examples of such products include solpadeine, maxilief (generic of soluble solpadeine), migraleve and nurofen plus. Feminax has gone off the market. These are all combination products - ie they contain a painkiller such as paracetamol along with codeine. Codeine on its own has very little pain-killing properties and exists in products such as Codinex but this is not indicated to relieve pain but instead to suppress a dry cough.
WHY THE REGULATIONS?
Codeine is an opioid analgesic (painkiller of the opioid class - other drugs in this class include morphine and methadone, however it is a weak opioid).
1. It is highly addictive, hence should not be used for more than 3 consecutive days at a time, and only as required. This does not mean you NEED to take it every 6 hours for 3 days. If the pain goes away after one dose then that is enough.
2. Codeine can also cause constipation and often in pharmacy we find patients complaining of being constipated and when we ask about other medicines, they take codeine-containing products regularly, and often unnecessarily.
3. The reason you’re asked if you’ve tried something else already is because often painkillers such as ibuprofen or paracetamol will help with pain associated with minor ailments such as headache and stomach cramps, without the need for an opioid analgesic with side effects. Codeine can also make you feel dizzy/drowsy so you should not drive if affected.
4. Whenever medication is prescribed/recommended by a health professional, or even when self medicating, it is important to consider benefit versus risk. If your pain can be relieved by a simple painkiller such as paracetamol, why take extra drugs such as codeine phosphate hemihydrate and caffeine (as are the additional ingredients in solpadeine) as well? The risk of the side effects far outweigh the benefit of the pain-kiling properties as the symptoms could have been solved with simple paracetamol. Always consider benefit vs risk and educate yourself about such benefits and risk by asking your pharmacist what the best product is for you and have that conversation. It is important that we do not just take the medicine we are used to, and that we take the medicine that is BEST for what our current symptoms are instead, whilst taking into consideration other medications we may now be taking that we were not on the last time we took an over the counter preparation.
SO WHEN MIGHT I NEED CODEINE CONTAINING PRODUCTS?
If, and only if, you have tried something else already for the pain, and after describing your symptoms in full to your pharmacist/doctor. Be honest when answering questions regarding codeine use. Pain such as serious dental pain or period cramps not relieved by a proper course of regular analgesics May warrant the short term use of such a product. It is not an investigation or an accusation of addiction, it is just to ensure safe and correct usage of drugs in the interest of your health and well-being. As with all over the counter products, they should be used for a short time only, and if they do not relieve symptoms or symptoms worsen, you should see a doctor as soon as possible to find out the cause of the symptoms. Remember cause and effect; a painkiller will help ease the pain of a toothache, for example, but will not treat the abscess causing the pain. Recurring headaches need to be investigated further and codeine can cause rebound headaches. It should not be your go-to! If you have any further questions, pop them in the comments or send me an email (firstname.lastname@example.org).
Sometimes your doctor may prescribe a codeine-containing product, but again this will usually be to relieve pain and taken as required. Take only as needed and not just according to maximum daily dosage if this is the case. If you find the dizziness/constipation side effects are affecting you, speak to your doctor or pharmacist and they will help you come up with a solution to target your pain without having such side effects and may recommend a different medication regime.
The more we educate ourselves about our health and what we put into our bodies, the more our bodies will thank us in the future. Take only what you need to relieve pain. Taking more than this can potentially damage our vital organs such as our liver and kidneys and lead to serious addiction which can affect our mental and physical health.
if you have been affected by this topic or if codeine addiction affects you or someone you know, here are some helpful links and helplines. Don't be alone and know that you are always welcome to speak to a health professional such as your pharmacist or doctor, or even to a friend or family member.
Drugs and Alcohol helpline: Freephone: 1800 459 459 (mon-fri 9:30 - 5.30 pm)
Take care and remember that knowledge is power!!
sending love and positive thoughts,