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Codeine abuse leads to calls for painkiller rethink
Senior health officials are warning of a looming public health crisis from abuse of over-the-counter painkillers.
Doctors are frustrated by admissions of critically injured patients to emergency rooms after sustained use of painkillers that contain a mixture of codeine and ibuprofen, such as Nurofen Plus.
While many take the drugs responsibly, the consequences for those who do not can be so severe that some doctors and pharmacists believe its time to review the sale of these drugs.
Frankie Bean began using Nurofen Plus 24 hours a day to stave off the chronic pain of Lupus disease, an auto immune condition that leaves her in pain every day.
"Initially it was just that I could work and I could have my life back and I was really excited about that, so I was just willing to do whatever it took to do that," she told ABC1's 7.30.
"But then I sort of started realising that I was a bit hooked on it. I didn't want to be, but I didn't want to give up my life again."
The constant use of pain killers lowered her blood pressure so badly she passed out at work.
The next thing I knew my sister was by my side balling her eyes out and I was passed out out the front of my work and I was on the ground and there were ambulance people around me taking me off to the hospital.
Frankie Bean
"I was just at work and I hadn't felt good in the morning, like I was getting a bit dizzy and stuff and I just put it down to Lupus," she said.
"The next thing I knew my sister was by my side balling her eyes out and I was passed out out the front of my work and I was on the ground and there were ambulance people around me taking me off to the hospital."
Weeks later Ms Bean quit cold turkey and now says she will never take the tablets again.
"I had headaches, I vomited a lot, I was absolutely horrible to be around," she said.
"It is something that people don't realise, I had no idea that I could get addicted to codeine."
Now she has turned to yoga every morning to help with the joint pain.
Heroin relative
Doctor Matthew Frei runs a drug treatment clinic in Melbourne and knows first hand how addictive codeine can be.
"It is a close relative of drugs like morphine and heroin, so yes, it is an addictive drug," he said.
"We're a bit unusual in Australia in that you can purchase codeine over the counter, that's not the case in all parts of the world."
It is quite a scary and foreign idea to someone who has not had much contact with the drug-using culture to be offered a treatment that's usually offered to heroin addicts.
Dr Matthew Frei
Dr Frei published a study on 27 Australians who had to go on morphine just to get off codeine.
"It is quite a scary and foreign idea to someone who has not had much contact with the drug-using culture to be offered a treatment that's usually offered to heroin addicts," he said.
"However, the principles of addiction to codeine or prescription opioids, to all the opioids are very similar."
Back in the 1950s and 1960s people were getting addicted to Bex headache powder, which contained caffeine.
The serious problems that resulted saw them banned in 1977.
Dr Frei says drug addiction is a marketing manoeuvre for these over-the-counter pain killers.
"It's using an anti-inflammatory agent, linking it to another drug which causes the patient to keep on taking it because of the withdrawal symptoms they get when the effect wears off, and thereby accumulating bigger and bigger doses," he said.
"This is headache powders revisited."
Today's compound analgesics are known by their popular brand names like Nurofen Plus, Panafen Plus and Mersyndol.
The codeine in the drugs gets consumers hooked, but the real danger is the ibuprofen they contain which in large doses is toxic and can cause internal bleeding.
'Giant ulcer'
One of my worst moments in the last few years was when I was up all night with a young man who was otherwise well, who was bleeding torrentially from a giant ulcer in his stomach which was caused by compound analgesics.
Dr Aidan Foy
The director of general medicine at Newcastle's Mater Hospital, Doctor Aidan Foy, has seen patients with life threatening conditions from over the counter codeine.
"The peptic ulcers can also be lethal, in fact, one of my worst moments in the last few years was when I was up all night with a young man who was otherwise well, who was bleeding torrentially from a giant ulcer in his stomach which was caused by compound analgesics," he said.
There has been at least one death from over the counter codeine in Australia and Dr Foy says it was only through good fortune that this young patient survived.
"This man needed 14 units of blood and we were running out of blood, and by the time he was anesthetised, he was in really big trouble, but fortunately for him there was a very good surgeon handy who moved quickly and stopped the bleeding and he has now recovered," he said.
Since 2008 doctors around the country have been documenting scores of cases of codeine abuse some leading to peptic ulcers, kidney failure and even pancreatitis.
Dr Foy says it is extremely frustrating to see young people turn up with life threatening conditions created by codeine and ibuprofen abuse.
"It is an extremely unpleasant sensation to be up in the middle of the night with somebody who looks as though they're going to die to no purpose. It's pointless," he said.
Codine road trips
Michael Meaney runs a pharmacy in Sheffield, a small town in north-west Tasmania, and has been trying to stop codeine road trips.
"I've had people come from as far as Smithton 150 kilometres away and Launceston 100 kilometres to the east away coming here to buy codeine-based products from my pharmacy in Sheffield," he said.
Now taking the law in to their own hands, Mr Meaney and other local pharmacists use software designed to track sales of pseudoephedrine, a key component of amphetamines.
It involves recording the license details of customers to stop codeine road trips.
"Project Stop hasn't been approved for codeine sales, but we're doing it because we think it's the lesser evil to perhaps infringe on people's personal privacy, to infringe on these privacy laws rather than allow a handful of people to do enormous damage to themselves," he said
link http://www.abc.net.au/news/2012-11-...for-painkiller-rethink/4356816?section=justin
Senior health officials are warning of a looming public health crisis from abuse of over-the-counter painkillers.
Doctors are frustrated by admissions of critically injured patients to emergency rooms after sustained use of painkillers that contain a mixture of codeine and ibuprofen, such as Nurofen Plus.
While many take the drugs responsibly, the consequences for those who do not can be so severe that some doctors and pharmacists believe its time to review the sale of these drugs.
Frankie Bean began using Nurofen Plus 24 hours a day to stave off the chronic pain of Lupus disease, an auto immune condition that leaves her in pain every day.
"Initially it was just that I could work and I could have my life back and I was really excited about that, so I was just willing to do whatever it took to do that," she told ABC1's 7.30.
"But then I sort of started realising that I was a bit hooked on it. I didn't want to be, but I didn't want to give up my life again."
The constant use of pain killers lowered her blood pressure so badly she passed out at work.
The next thing I knew my sister was by my side balling her eyes out and I was passed out out the front of my work and I was on the ground and there were ambulance people around me taking me off to the hospital.
Frankie Bean
"I was just at work and I hadn't felt good in the morning, like I was getting a bit dizzy and stuff and I just put it down to Lupus," she said.
"The next thing I knew my sister was by my side balling her eyes out and I was passed out out the front of my work and I was on the ground and there were ambulance people around me taking me off to the hospital."
Weeks later Ms Bean quit cold turkey and now says she will never take the tablets again.
"I had headaches, I vomited a lot, I was absolutely horrible to be around," she said.
"It is something that people don't realise, I had no idea that I could get addicted to codeine."
Now she has turned to yoga every morning to help with the joint pain.
Heroin relative
Doctor Matthew Frei runs a drug treatment clinic in Melbourne and knows first hand how addictive codeine can be.
"It is a close relative of drugs like morphine and heroin, so yes, it is an addictive drug," he said.
"We're a bit unusual in Australia in that you can purchase codeine over the counter, that's not the case in all parts of the world."
It is quite a scary and foreign idea to someone who has not had much contact with the drug-using culture to be offered a treatment that's usually offered to heroin addicts.
Dr Matthew Frei
Dr Frei published a study on 27 Australians who had to go on morphine just to get off codeine.
"It is quite a scary and foreign idea to someone who has not had much contact with the drug-using culture to be offered a treatment that's usually offered to heroin addicts," he said.
"However, the principles of addiction to codeine or prescription opioids, to all the opioids are very similar."
Back in the 1950s and 1960s people were getting addicted to Bex headache powder, which contained caffeine.
The serious problems that resulted saw them banned in 1977.
Dr Frei says drug addiction is a marketing manoeuvre for these over-the-counter pain killers.
"It's using an anti-inflammatory agent, linking it to another drug which causes the patient to keep on taking it because of the withdrawal symptoms they get when the effect wears off, and thereby accumulating bigger and bigger doses," he said.
"This is headache powders revisited."
Today's compound analgesics are known by their popular brand names like Nurofen Plus, Panafen Plus and Mersyndol.
The codeine in the drugs gets consumers hooked, but the real danger is the ibuprofen they contain which in large doses is toxic and can cause internal bleeding.
'Giant ulcer'
One of my worst moments in the last few years was when I was up all night with a young man who was otherwise well, who was bleeding torrentially from a giant ulcer in his stomach which was caused by compound analgesics.
Dr Aidan Foy
The director of general medicine at Newcastle's Mater Hospital, Doctor Aidan Foy, has seen patients with life threatening conditions from over the counter codeine.
"The peptic ulcers can also be lethal, in fact, one of my worst moments in the last few years was when I was up all night with a young man who was otherwise well, who was bleeding torrentially from a giant ulcer in his stomach which was caused by compound analgesics," he said.
There has been at least one death from over the counter codeine in Australia and Dr Foy says it was only through good fortune that this young patient survived.
"This man needed 14 units of blood and we were running out of blood, and by the time he was anesthetised, he was in really big trouble, but fortunately for him there was a very good surgeon handy who moved quickly and stopped the bleeding and he has now recovered," he said.
Since 2008 doctors around the country have been documenting scores of cases of codeine abuse some leading to peptic ulcers, kidney failure and even pancreatitis.
Dr Foy says it is extremely frustrating to see young people turn up with life threatening conditions created by codeine and ibuprofen abuse.
"It is an extremely unpleasant sensation to be up in the middle of the night with somebody who looks as though they're going to die to no purpose. It's pointless," he said.
Codine road trips
Michael Meaney runs a pharmacy in Sheffield, a small town in north-west Tasmania, and has been trying to stop codeine road trips.
"I've had people come from as far as Smithton 150 kilometres away and Launceston 100 kilometres to the east away coming here to buy codeine-based products from my pharmacy in Sheffield," he said.
Now taking the law in to their own hands, Mr Meaney and other local pharmacists use software designed to track sales of pseudoephedrine, a key component of amphetamines.
It involves recording the license details of customers to stop codeine road trips.
"Project Stop hasn't been approved for codeine sales, but we're doing it because we think it's the lesser evil to perhaps infringe on people's personal privacy, to infringe on these privacy laws rather than allow a handful of people to do enormous damage to themselves," he said
link http://www.abc.net.au/news/2012-11-...for-painkiller-rethink/4356816?section=justin
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")
