I believe doctors would prescribe actual codeine addicts bupe but not people using codeine twice a week, bit of a difference.
I know, I didn't say you, just said its an option to people out there that are using more often.
I have to say that is a pretty big assumption to make that the majority will end up addicted. I really don't think that if you looked at the amount of people who use codeine regularly that a good majority of them would end up with real dependencies on it. For many tolerance limits ones ability to really become dependent on codeine, like if I use codeine much more than once or twice a week my tolerance skyrockets. I *could* just use every single day with next to no effect, but there isn't really any benefit to me doing it, I think I would realise it wasn't worth my while to spend that much everyday not getting high compared to spending less and catching a buzz once or twice a week. Throw occassional access to harder opiates in the mix and tolerance becomes a hugely limiting factor on ones propensity to become hooked on codeine.
That is the issue, most people turn to harder drugs, look at mr blondes posts saying he will start looking for morphine as codeine is too expensive etc. You are right, not all will or do, but plenty certainly do, and having this information available to them is HR.
One issue/question you have not addressed, is why do you believe someone using codeine a few days a week is better off being on ORT? Codeine is relatively inexpensive and has relatively few harmful effects, there are costs and side effects associated with ORT too. If someone can afford their codeine habit, however large or small, then as I see it they are doing themselves relatively minimal harm and whether they change to ORT or not wont really change that. I keep coming back to the conclusion you must believe there is something inherently wrong with getting 'high' on opiates, as that is the only thing that would really change on bupe.
I don't think they are all better off, I just suggested it as a possibility for some people, I'm sure there are plenty that it would make the situation worse just like you described, but there are also others that it could help get them out of a bind. They should be able to diagnose what category they are in along with the help of addictionologist.
Something inherently wrong? Well a lot of the time people are using it as a bandaid to them feeling shit, mental illness or just boredom, if you can treat it like your few drinks on the weekend then more power to you, just unlike alcohol codeine CAN lead to opiate dependency on stronger drugs that can really drag your life down. If this is not an issue, then you are right, bupe would not be of any use.
I am also curious what your thoughts are when I suggest DHC as a better starting option than bupe to help someone maintain or taper a codeine habit? I am by no means an expert on ORT but if someone is addicted to an opiate as mild as codeine it would seem easier on the addict to give them the lowest potency maintenance possible, so as to not actually end up increasing their level of physical dependence.
DHC is great for quitting codeine, only prob is you are dispensing it yourself, you aren't get a specific dosage daily from a chemist. This leaves the problem of willpower, most people will just go fuck it and use it all, either not fixing the problem or making it worse, I know it did with me.
If you do have the will power to use DHC to quit codeine, you probably have enough to do it cold turkey. Bupe is for the addicts that really struggle with the psychological side of quitting, the daily dispensing so you cant use your supply in a week, the fact you don't catch a buzz so you get used to the sober life style, and the slow taper.
If you don't need all of the above, or if you don't even feel that codeine is detrimental to your lifestyle (it usually isn't, it is just what it can lead to that can be) then bupe is probably of no use to you, for many of the reasons you suggested.