I always try to use a small enough volume of water with Paramol to allow plugging at least half of the solution. I don't know if it's placebo, but it seems a lot more powerful than codeine that way. A BA issue, perhaps? I think I read somewhere that DHC's rectal BA is significantly higher than oral. Always did find it far more satisfying than codeine when taken orally though, but not quite as snuggly, which is probably a factor in some people not liking it. Mileage definitely seems to vary though, doesn't it?
You're right about the ridiculous price.