Call for action as 115 deaths linked to pain pills

[Jabberwocky]

Call for action as 115 deaths linked to pain pills

Revelations of a spate of deaths caused by the misuse of a popular painkiller have led to calls for tougher restrictions on the anti-inflammatory pill.

Melbourne researchers combed a decade of Victorian coroners' data and found 115 cases in which codeine and ibuprofen were both detected, including 63 examples in which drug toxicity was the cause of death.

Nine cases between 2001 and 2011 could be directly linked to the internal damage caused by long-term misuse of the tablets, including gastric erosions and ulceration.


There are six painkillers on the market in Australia that contain ibuprofen and codeine, the most popular of which is Nurofen Plus. Others include Pharmacor Ibuprofen Plus, ProVen Plus, Rafen Plus, Panafen Plus and Chemists' Own Ibuprofen Plus Codeine.

Some people have been known to take up to 100 tablets a day, travelling from chemist to chemist to fuel their habits. Despite 2010 laws limiting the size of doses available, the reports of misuse are only increasing.

Jennifer Pilgrim, a researcher at Monash University's Department of Forensic Medicine, co-authored the new study and explained that while ibuprofen was the ingredient that caused deaths it was the codeine that created addiction.

It is for that reason experts including a senior medical adviser with the Victorian government have called for the pill to be restricted to prescription-only or for codeine to be banned from over-the-counter products. Dr Pilgrim said the other alternative was for chemists to monitor the quantity of drugs bought by each person. ''All those options involve more input from prescribers and the pharmacist, but that is the only way the situation is going to be managed,'' she said.

In one case, a 48-year-old woman who died after abusing Panafen Plus had already been identified as a doctor shopper and had restricted access to prescription medicines. But Dr Pilgrim said she was still able to travel to multiple chemists to gather large quantities of codeine.

''The coroner actually made a point of saying the problem in this case is the drugs that she can access over the counter quite easily were the ones that killed her,'' Dr Pilgrim said.

The clinical director of Melbourne's Turning Point Alcohol and Drug Centre, Matthew Frei, continues to lobby for larger warnings on packets. Last week he came across one of the most extreme cases of over-the-counter codeine abuse he had seen, a man in hospital for low potassium who was taking more than 100 tablets a day.

Dr Frei said those addicted to the pills often had a similar story. Many became hooked after starting to take the tablets for legitimate pain.

Mulwala man Travis Rowe is on a rehabilitation program after a 10-year Nurofen Plus addiction that resulted in him being sent to prison for 13 months because he often drove unlicensed to visit chemists in other towns in NSW and Victoria.

Mr Rowe, 43, started taking Nurofen Plus when he had a sore shoulder, but his habit escalated to 50 tablets a day after he lost his job. The addiction cost him $400 every week in pills alone.

''Now I can spend time with my kids, my yard looks good, I don't have blues with my missus,'' he said.

The Australian Self Medication Industry, a healthcare products lobby group, said it had been looking at ways to support safe use of codeine-combination products, including label warnings. However, it said it was important to keep in mind most people used the medication appropriately.

http://www.smh.com.au/victoria/call...aths-linked-to-pain-pills-20130918-2tyw0.html

 

[drug_mentor]

Hey mate, I moved your posts from the drug busts thread to make its own thread, because it isn't really a drug bust. I also wanted to comment on it and we don't allow that in the drug busts thread. haha

Their "painful truth" section is laughable, codeine is an opiate, not an opioid. Also, Mydol, Panadeine Extra and whatever other brands contain 15mg of codeine are all stronger than Nurofen + which has just 12.8mg of codeine, that shit is really not hard to research or find out. Who are these jokers who write this shit with such little fact checking.

I really hope this doesn't lead to stricter controls on these drugs than there already are, I am thankful to live in a country that allows some otc opiate based pain relief, it would be a real shame if they were to go backwards on this because of a few idiots who gobble these pills like candy. As a side note, I honestly can't believe people still do this shit, if the news outlets, pharmacy guild, government or anyone gave a shit about these people they would make the information on CWE more available than it already is. Still, the information is so easily accessible the people not doing it have little excuse.

The most ridiculous part about this whole issue is if pure codeine tablets were otc like they are in France (Paderyl if you are ever there!) then there wouldn't be any problems, all these negative effects are associated with paracetamol and ibuprofen when the addicts are taking them for the codeine. How is the solution to ban the useful, sought after drug and keep the useless and damaging ones available.

 

[lovepsychadelics]

Who are these jokers who write this shit with such little fact checking.

Journalists with 0 journalistic integrity and a desire to sell papers, they should have worked for the Sun lol.

The most ridiculous part about this whole issue is if pure codeine tablets were otc like they are in France (Paderyl if you are ever there!) .

They sure are 20 mgs or 30 mgs from memory just walk into any chemist in Paris and ask for the strongest pain meds they can give you OTC for bursitis or disk problems especially in winter.

Most of the French have good english and are more than happy to help someone from overseas on holiday in winter when you explain the cause of your pain. The EU is really becoming very anti-war on drugs. Also the French are starting to dislike America/Americans in a big way, not as much as they dislike poms though lol.

On a different note in the UK OTC means 10mg codeine and 500mg paracetamol is the best you can hope for. My back locked and I couldn't even stand once when I was sitting reading for 30 minutes and forgot to turn on the heater. I couldn't stand up and the pain when being lifted to standing was immense add a drive in the country side, because the people your staying with are more concerned with showing you a shitty little town with almost 0 employment and over 45 pubs for a population of around 8000-10000 odd people. Lovely country side though and if it was not so beautiful I would have spat the dummy.

When your in this much pain I was a very unhappy tourist and I didn't give 2 shits that some of the building were 300-400 years old. Luckily I had some MXE on hand and after my painful and somewhat shit tour of "bongleton", nicknamed cause that is all there is to do there, I hit 35 mg MXE and finally could ambulate without agonizing pain. It's the brufen/ibuprofen that causes the deaths due to organ failure and massive bleeding, often internal.

 

[tentram]

restrict codiene even further, dont lower the dose of the anti inflammatories that are the main cause of the toxicity!

 

[infectedmushroom]

If one calculated the percentage of those who abused OTC codeine relative to those who used it for legitimate pain purposes you'd probably find an absolutely minutiae proportion do the former.

Banning it OTC would really fuck over the %99 of people who need it for legit pain let alone the pharmacies who I'm sure make a good chunk of change from OTC sales. I dont foresee it being made prescription only; some chemists already will ask for details upon purchasing, so maybe that policy will be more strongly enforced instead.

I hope not, though. This is shitty sensationalist journalism; in the scheme of things unsafe OTC codeine abuse is almost negligible relative to the cost of other drug issues in our country.

 

[footscrazy]

Their "painful truth" section is laughable, codeine is an opiate, not an opioid.

To be fair it can accurately be called an opioid, as 'opioids' include both opiates and synthetics, whilst 'opiate' is restricted to naturally occurring alkaloids. Then again, doing a quick search it does seem some sources use 'opioid' to refer only to synthetics - I'd always used opioid as the catch all term though, whereas opiate does refer to something specific. I absolutely agree with the rest of your post.

 

[lovepsychadelics]

To be fair it can accurately be called an opioid, as 'opioids' include both opiates and synthetics, whilst 'opiate' is restricted to naturally occurring alkaloids. Then again, doing a quick search it does seem some sources use 'opioid' to refer only to synthetics - I'd always used opioid as the catch all term though, whereas opiate does refer to something specific. I absolutely agree with the rest of your post.

An opioid drug are usually synthetic mimics that have some Mu receptor activity, shit like tramadol aka rat poison! An opiate generally refers to a drug that is actually derived (often via a heap of synthetic synthesis) from opium eg oxycodone. Opioid can be used as a catch all but you will never see tramadol described as an opiate. I'm amused by this whole "synthetic" thing especially as it's being used in the media to describe RC's while all drugs are really synthetic as they are synthesized via a series of chemical reactions to modify the molecular structure of a drug/medication.

I doubt journalists are taught anything about pharamcology/pathophysiology/organic chemistry or anything else that would qualify them to make statements such as those outlined. Best for a journalist with actual journalistic integrity to approach someone with some kind of formal qualification in these fields before talking out of their ass.

As to tramadol being an opioid tentram re-read my first sentence. Sometimes opioids/opiates are used as a catch all for these 2 distinct classes of drugs because medical professionals are human or just being lazy, another example could be "diaz" to refer to diazepam. This is despite being very familiar with the pharmacology and pharmacodynamics of these substances. Basically Tentrum your post supports my statement that tramadol is an opioid so why did you bother unless you misread/misunderstood me???

 

[tentram]

^tramadol is regarded an opioid.

 

[Captain Brewster]

Nine cases between 2001 and 2011 could be directly linked to the internal damage caused by long-term misuse of the tablets, including gastric erosions and ulceration.

9 in 10 years? I feel sorry for these people because they didn't discover CWE, not because codeines OTC.

Anyone got a comparison with deaths from alcohol in the past 10 years?

 

[gimpan]

restrict codiene even further, dont lower the dose of the anti inflammatories that are the main cause of the toxicity!

I dont know. I think the governments worries are somewhat valid, Just take a look at the amount of people claiming to be struggling with codeine on bluelight.

 

[Captain Brewster]

I dont know. I think the governments worries are somewhat valid, Just take a look at the amount of people claiming to be struggling with codeine on bluelight.

I think their worried about the wrong thing. Money.

Have a look around, I think there's more people struggling with alcohol addiction. But are they going to make that prescription only?

 

[oldirtybizza]

9 proven cases of death in a decade. It's a goddamn epidemic. Why does anyone even give a shit? as soon as any harm that's related to psychoactives happens it's hysteria.

+1 for France but it comes a distant 2nd to Spain , Codeisan all the way and they've got those effervescent orange flavour 30mgs too. quite the treat.

I don't understand how those countries still exist surely such things being OTC must lead to foaming at the mouth, mass rape , murder and total societal collapse.

 

[gimpan]

I think their worried about the wrong thing. Money.

Have a look around, I think there's more people struggling with alcohol addiction. But are they going to make that prescription only?

If it was about money the government would want people to have easier access to pharmaceuticals so more taxes can be collected.

 

[gimpan]

I'm assuming that because you're a bit of a smartass yourself most of the time, that tentram's sarcasm wasn't lost on you and say that people don't struggle with codeine. It might be a lot of people's starting point, but for the most on bluelight it's probably just a maintaining measure?! OR I could be way off the mark.

I dont know. I was just pointing out that alot of people here talk about being addicted to codeine, but at the same time call for relaxing laws on drugs.

Does anyone know if adding paracetamol or ibuprofen to pills is a legal requirement?

 

[Captain Brewster]

^ it's a legal requirement to have a prescription for codeine only tablets, if you contain them that is.

 

[Not Again]

Some people have been known to take up to 100 tablets a day

Um, I think anyone taking anything like that is going to have some problems.

 

[tentram]

lovepsych - sorry, misread your statement. it is a fully synthetic opiod n not an opiate as you said.

 

[Cartesia]

For the record, im probably one of the more experienced codeine addicts (clean now finally). 2005-2012

Ive seen/heard in public bathrooms/etc plenty of people necking 30+ pills without cwe. Secondly ive been through a period in my time when i wasnt extracting, and if people around me had not expressed concern at my health (severely pale, sleeping constantly), i likely wouldve died. I had no serious gastric injuries, but had bugger all iron/red blood cells in my body - everyone was surprised. Was alive at the level it was at, if it had gone on longer? Heart attack most likely... so it is hurting people seriously. Some alot moreso... at least i was aware what i was doing, i dont think alot are even aware of cwe. Id see empty packs lyimg around all the time in a toilet cubicle or something, but never any signs of a ghetto cwe, which i did plenty anywhere i could find a fast food restaurant and a bathroom.

I dont even wanna know the state of someone's body who eats a pack of para+codeine pills everyday instead of ibuprofen.....

People cant be trusted to cwe... i say either provide codeine without other ingredients, or limit it. If someone is suffering strong pain, they *should* see a doctor about it rather than self-treat. Then doctors can just script N+ like it's candy for all i care to anyone who complains about a headache - nobody is going to prescribe enough for someone to get themselves seriously addicted no matter what the problem is though.

All you people still on it will probably hate me...i know i wouldve. but honestly, thats how it looks from this end.