Opioids Self medicating with codeine, am I making a mistake?

[movbikwaet]

I suffer terrible anxiety that makes most the day unpleasant. The only thing that helps really is anti psychotics but they are terrible, not only are they not fun but they made me obese and kill my sex drive.
I am off them now with the doctors okay. I have not spoken about valium with my doctor because my anxiety isnt debilitating.

I have been taking codeine daily for months, I have taken doses as high as about 90mg at a time and probably as much as 200mg in a day for recreation.

Currently I am down to 30mg being my highest dose and about 60mg max in a day, I am very pleased lowering my dose is still netting me a therapeutic effect.

I find my tolerance to the euphoric effects builds quickly but not its anti anxiety or anti depressant effects.

My psychiatrist asked me what I plan to do once it stops working and I said stop. Is this idea laughable?

Should I stop now? I have read that opioid therapy was useful before anti depressants were invented.

 

[Rybee]

May I ask what anti-psychotics you were using/used? I've only used Quetiapine (you may know it as Seroquel, Xeroquel or Ketipinor) for acute insomnia following Zopiclone (Ambien) withdrawal and it was the best sleep aid I've ever used. Made me feel awful but it literally knocked me out, even at 50mg which I think is a small dose in comparison to those who use it for psychosis. Still have a lot of them left and they're very useful for sleep, don't use them much though as I doubt I'll ever be p/x'd them again and I get p/x'd Alprazolam/Lorazepam/Diazepam/Zopiclone anyway.

That said, I gave up with the Alprazolam/Lorazepam/Diazepam because I got reasonable tolerant quite quickly and they were just rendered ineffective quite quickly, so like yourself, I turned to opiates as I always felt them quite sedating (Codeine/Morphine in particular, as opposed to Tramadol) and much more effective at settling my anxiety. Though like the Benzodiazepine tolerance, I soon developed a Opiate/Opioid tolerance and it just wasn't practical anymore. Which highlights my point re: what your Psychiatrist said.

So what do you do?

You either carry on taking it in doses that get higher each time to a point in which it is unsustainable... or you quit. Option A is inevitable, and Option B isn't nice.

Do you take anything else to ease your anxiety? Non opiate/opioid/benzodiazepine/psychotics? Something like Amitiyptyline/Dosulepin/Pregabalin/Gabapentin/SSRIs/SNRIs?

Opiates/Opioids/Benzodiazepines aren't a long-term solution. Things like TCAs/SSRIs/SNRIs can be. I came off of long term Lorazepam use (p/x'd and supervised by my Psych) because they just aren't sustainable. Not long ago I started Dosulepin, (you may know it as Dothiepin?) and at first I found it to be very sedatory (think I just made the word up?) in nature. Very hazy and tired for the first few weeks, and the days following a dosage increase, but my overall anxiety is down so much and I don't touch Opiates/Opioids/Benzodiazepines for anxiolytic relief anymore which is great.

Although he has a point, what are you going to do? As a Psychiatrist, has he not offered alternative suggestions and solutions that are long-term and sustainable?

Is your anxiety generalised/chronic/acute/panic attacks... If it is infrequent and acute you may be better off with something like a Beta-Blocker or a Benzodiazepine (just realised you'd not mentioned that, have you ever used them?) Or if it's generalised, and more chronic in nature, perhaps look at TCAs/SSRIs/SNRIs, or even Beta-Blockers can still be useful in long-term cases.

Just watch how much you take, try and cut down, and throw me back a reply when you can and we'll see if you've got some more options than just Codeine

Take care,

 

[TheLostBoys]

I think 60mgs Codeine a day is awesome for treating anxiety & you've been on it for months ......that's impressive that you haven't moved onto anything harder.

Obviously you are using it the right way & yes, pain meds were given out years ago before the ridiculous crap they hand out for depression/anxiety now a days.

If you tell a doctor you have anxiety now a days, they want yo put you on an SSRI.......its a complete joke!

This is why people take matters into their own hands "but" the toad of opiates can be dangerous if you get carried away.

I know people that been taking Tramadol or Vicodin for anxiety/depression for over 7 years straight & have not gone crazy on their meds, maybe its because they don't have addictive personalities? Which I know they don't........

Now a days, you will be very lucky to get s doctor that truly cares about his/her patients.

If Codeine is helping you thru tough times, especially at the low doses you ate taking, more power to you!

As long as you don't move up to oxy/dilaudid, etc........

 

[movbikwaet]

I have had a few medical procedures and opioids definitely work a lot better than benzos for me for anxiety, I always opt out of general anaesthetic.

My anxiety is generalized(restlessness, worry) and panic(phobias, somatization), I am on zoloft for the panic, and I have seroquel on hand if anything terrible happens to me.

I have been on seroquel and risperidone.

My codeine use started when I actually needed it daily for chronic pain for a year, I easily stopped and have been taking it on and off recreationally for a few years since, although lately I have been taking it daily which is a concern.
I was thinking of taking tolerance breaks, I know this exists because I experienced decreased tolerance myself.


The problem with my situation is it doesnt warrent AP or Benzo use, but its not the type of anxiety anti depressants treat and it responds so well to opioids.

I am under extra stress at the moment due to this shitty relationship I am in, it should be over soon and once it is I will half my dose again and see how my anxiety is.
I am also going to discuss options with my psychiatrist such as switching to effexor.


Also I want to point out I am lucky to of missed 2 opportunities to try oxy, they were recently prescribed to 2 family members for legitimate post surgery pain, I asked but never pushed them for some.

 

[Beavesmx44]

I used to take effexor and it personally gave me too many side effects.(tired, erection troubles, emotionally numb in a weird way) Now I occasionally self medicate with kratom(like codeine i suspect) and it is way more uplifting/functional. Pretty much for the same reasons as you.(anxiety, depression) Works way better and cost less than an ssri did. ymmv

 

[movbikwaet]

From what I have read opioid addiction depends on the person but that there are fine lines for example snorting heroin to injecting heroin being one. I know I fit the profile of an opioid addict (hard to bear and treat mental health issues).

Regarding my drug history I will document it so you guys can judge:


I am leaving out experimental usage, I have tried many drugs.

I have been smoking since I was 12 due to very acute stress at the time, I have quit for 9 months at the longest and only started again as a conscious decision because I was replacing the addiction with food and became overweight.

I had my heart broken and started using speed recklessly for about a year and only stopped because I couldn't get anything of decent quality anymore, although I found it extremely moreish I did not find it addictive at all and have not used it since.

I have occasionally taken cocaine when I can make the most use of it such as at a party but I find I sometimes react bad to it depending on the gear, and due to my anxiety I have now ruled out all narcotic stimulants.

I am currently addicted to coffee a brand I have found that has superior opioid activity and is not too anxiety inducing.

I used to drink on weekends when I was young but reserve alcohol as a social lubricant on dates or when I need to heavily socialise with other people drinking.

I really dont know whether to consider myself as having an addictive personality or not, I can be reckless.

 

[spacejunk]

^ coffee with opioid activity?

As for the codeine - if you have reduced your dose down to 30mg/day - I say well done; that's impressive.
I think that if you were able to do this, you would be able to taper down to nothing without too much discomfort.

The thing with codeine is that a lot of people just keep increasing their dose and their tolerance until they find codeine rather ineffective (or inconvenient with large daily doses required to keep from getting sick) - and they experiment with other opiates/opioids.
I can tell you from experience that once you start using other opiates, codeine will most likely become essentially useless to you.

It is certainly not impossible to quit every day use, and to your credit, you are using one of the mildest opiates at a very minimal dose - so I don't think it is a huge cause for concern.

My one piece of advice would be to be very strict with yourself not to use other opiates, even if the opportunity to experiment arises and tempts you.
Once you blow your tolerance out to a high level, it can take fairly drastic measures to rein it back in (such as a 'tolerance break' or period of abstinence). So long as you keep your dose as low as it is - and stick with codeine - I think it is a fairly manageable (if not medically orthodox habit).
You would be far, far worse off using benzodiazepines in the same way, and if managed correctly, I think any withdrawal symptoms you face at the cessation of a 30mg codeine habit could be much milder and gentler than withdrawals from certain anti-depressants, anti-psychotics and certainly benzos.
Obviously it isnt ideal to use any opiate daily, but you so long as you are reducing your intake rather than gradually increasing it - id say you're doing ok!

Non-drug treatments for anxiety can be quite effective for a lot of people - there are breathing and other physical/mental techniques that I have been shown by a psychiatrist after a traumatic incident that were incredibly helpful in calming panic and anxiety.

 

[movbikwaet]

Coffee has opioid activity FYI. A good brand is Illy btw but I use a local brand to Australia which is Vittoria special bar blend.

Thanks.
I am down to 60mg per day from 120. The strange thing I found with codeine myself is it wasnt the dose I was taking but rather my current tolerance and luck of the day. For example I can get just as drowsy and relaxed on 30mg as I can on 100mg depending on the day. When I started again and jumped from 30mg to 90mg I didnt not feel any increase in euphoria. Euphoria has either come to me randomly or from a tolerance break.

I am not really tempted at all the try harder opiates because I know apart from heroin its all essentially the same feeling once you are a frequent user, I have seen interviews on TV of people saying "Man I use heroin now just to feel normal!" fuck that.
I still occasionally enjoy good codeine(I felt so good last night on 30mg codeine) and nicotine rushes thats good enough for me.

I do meditate and use other CBT techniques, I also understand I need to face phobias and such.

I am seeing my psychiatrist soon, I will tell him I have lowered my dose, its still doing its job and I have no plan to move on to anything harder and see what he says but last time I saw him he got me worried cause he is an addiction specialist and he said to me "I dont want to be prescribing you methadone" and the last thing he told me before I walked out was "Do me 1 favour... stop the codeine".

 

[spacejunk]

I assume you are doing cold water extractions on OTC pain pills?

 

[movbikwaet]

I assume you are doing cold water extractions on OTC pain pills?

Nope, I tried this once but could taste too much apap.

My long term plan is I am either going to consult a family member doing chem engineering in university, or find a doctor to prescribe me codeine from a compounding pharmacy.

 

[TheLostBoys]

You have to understand that psychiatrists/doctors would rather prescribe you something that's gonna turn you into a zombie & has lots of side effects than somwthi g that makes you feel good/puts a smile on your face & takes care of anxiety/depression.

If you can control the intake of codeine & you font move onto anything harder I see nothing wrong with continuing the self medication of codeine.

 

[abracadabra girl]

I have been on seroquel and risperidone.

If you've only tried 2 there's still a lot you can try. Truthfully though most of the older APs do lead to weight gain. Notable exceptions are Abilify (which works wonders for a lot of people) and Geodon (which isn't usually as successful). But before Effexor, I would ask the doc about Abilify. Good luck to you.

 

[spacejunk]

Nope, I tried this once but could taste too much apap.

My long term plan is I am either going to consult a family member doing chem engineering in university, or find a doctor to prescribe me codeine from a compounding pharmacy.

Hmmm.
You realise that tasting the broken down pill means that you weren't consuming dangerous amounts of NSAIDs though, right?
As a former addict I can respectfully inform you that very few doctors in (if any) would consider prescribing any opiate for anything but pain. It's too much hassle and professional risk for them.
My biggest concern would be your consumption of the other, far more acutely toxic NSAID drugs than the more physically benign codeine.
In the name of HR I would thoroughly recommend this thread.
IMO consuming the other actives in OTC painkillers is nothing to be complacent about.

 

[VoidThe Scriptboy]

Coffee has opioid activity FYI. A good brand is Illy btw but I use a local brand to Australia which is Vittoria special bar blend.

Thanks.
I am down to 60mg per day from 120. The strange thing I found with codeine myself is it wasnt the dose I was taking but rather my current tolerance and luck of the day. For example I can get just as drowsy and relaxed on 30mg as I can on 100mg depending on the day. When I started again and jumped from 30mg to 90mg I didnt not feel any increase in euphoria. Euphoria has either come to me randomly or from a tolerance break.

I am not really tempted at all the try harder opiates because I know apart from heroin its all essentially the same feeling once you are a frequent user, I have seen interviews on TV of people saying "Man I use heroin now just to feel normal!" fuck that.
I still occasionally enjoy good codeine(I felt so good last night on 30mg codeine) and nicotine rushes thats good enough for me.

I do meditate and use other CBT techniques, I also understand I need to face phobias and such.

I am seeing my psychiatrist soon, I will tell him I have lowered my dose, its still doing its job and I have no plan to move on to anything harder and see what he says but last time I saw him he got me worried cause he is an addiction specialist and he said to me "I dont want to be prescribing you methadone" and the last thing he told me before I walked out was "Do me 1 favour... stop the codeine".

Great job on controlling your dose. I know how bad you have to grit your teeth during a time you'd normally have enough in your system. Waiting for the next dose can really suck. I have a lot of teeth pain (not from gritting my teeth, hah) and barely anything for it so I have to deal with the pain about 70% of the day, controlling the urge to take more. Good luck!

I am however buying some new coffee now.


Also, that's only when he's nice enough to prescribe me anything. It's a "waiting game"....a ten thousand dollar waiting game.

 

[Rybee]

I have had a few medical procedures and opioids definitely work a lot better than benzos for me for anxiety, I always opt out of general anaesthetic.

My anxiety is generalized(restlessness, worry) and panic(phobias, somatization), I am on zoloft for the panic, and I have seroquel on hand if anything terrible happens to me.

I have been on seroquel and risperidone.

My codeine use started when I actually needed it daily for chronic pain for a year, I easily stopped and have been taking it on and off recreationally for a few years since, although lately I have been taking it daily which is a concern.
I was thinking of taking tolerance breaks, I know this exists because I experienced decreased tolerance myself.


The problem with my situation is it doesnt warrent AP or Benzo use, but its not the type of anxiety anti depressants treat and it responds so well to opioids.

I am under extra stress at the moment due to this shitty relationship I am in, it should be over soon and once it is I will half my dose again and see how my anxiety is.
I am also going to discuss options with my psychiatrist such as switching to effexor.


Also I want to point out I am lucky to of missed 2 opportunities to try oxy, they were recently prescribed to 2 family members for legitimate post surgery pain, I asked but never pushed them for some.

May I ask what you mean when you say 'it doesn't warrant AP or Benzo use' ?

Effexor (Venlafaxine) destroyed my life for 2 years. I was dosed at 425mg (75mg over the licensed dose). I know everyone is different, but it changed my life for the worst so much. What's worse is I was naive to what I was taking, I was in such a severe state of depression and didn't really understand what I was taking and my old Pscyh insisted I stay on it for 12 months.

I've withdrawn from many types of drugs and Venlafaxine was torture, and I mean that in a literal sense. It took me 6 months to withdraw, I felt like my brain was being electrocuted every few hours, it was like medically induced electroconvulsive therapy. I used to have 3-4 nightmares every night and sweat so much in my sleep that I had to wash my bedsheets every single day. The insomnia was horrendous... just everything. I'm surprised they don't use it in torture camps. My new Psychiatrist prescribed me a hell of lot of Valium to help with the w/d effects. I was in such a vulnerable state when I was taking it and I have so much anger/resentment towards the Psychiatrist who put me on it. It literally ruined my life. Please, please, please read up and research about it before you take it.

I just urge you to take caution in what you're letting yourself in for. You may be fine, it may be a miracle cure for you. It's a complicated drug and affects the reuptake of Serotonin, Norepinephrine and Dopamine all at different doses.

 

[movbikwaet]

May I ask what you mean when you say 'it doesn't warrant AP or Benzo use' ?

Well if AP was the only option I would rather deal with the anxiety, with AP there is boredom and the physical side effects. I am not sure what Benzos are meant to be prescribed for tbh but I think its only occasional debilitating anxiety or short term anxiety.
My psychiatrist has warned me effexor is hard to come off, I would probably come off it over a very long time, cutting pills in to tiny bits towards the end.

 

[granddeception2]

APs are the worst I've been given my entire life. My doctor told me nothing about zyprexa. I used to be normal now I'm just a slave to this crap.

 

[falsifiedhypothesi]

If antidepressants and antipsychotics are out of the question than opiates seem to me like a much better choice than benzos. Benzos seem to have a really harsh backlash that involves more anxiety and depression than opiates. If opiates are used responsibly they can be very therapeutic for anxiety. The problem is when using them for mental illness it seems they are much more addictive than when used for pain.

When and if you decide to stop there might be some withdrawals which include anxiety and depression, but for me it's much better than benzo withdrawals. If you can manage opiates than they are great.

 

[spacejunk]

Yeah; if 30mg of codeine is effective in treating your anxiety, I daresay you do not need to escalate into more medically accepted psychiatric medication.
Certainly not anti psychotics, nor benzodiazepines.
You only need to read a few people's experiences with habituation and problems caused by either on bluelight to see that codeine is pretty benign (even when withdrawing from the dose you're on - most people who have experienced both seem to rank benzo WD as far worse than kicking even a heavy opiate habit).

I urge you to consider doing cold water extractions on your tablets though.
Not for any reason but out of concern for your health
Are you using ibuprofen or paracetamol w/codeine? Each carries different risk, but neither is particularly good thing to be taking daily for long periods of time.

If you learn to deal with the taste, you will greatly reduce the risk of causing damage to your liver, stomach or other problems.
It is ridiculously cheap and easy to do, and so worthwhile that I would suggest quitting altogether. There's no reason to be eating NSAIDs every day, even if you're not taking what are regarded as dangerous amounts each day - it's a totally unnecessary health risk; especially when it can be so easily removed.

 

[Rybee]

You have to understand that psychiatrists/doctors would rather prescribe you something that's gonna turn you into a zombie & has lots of side effects than somwthi g that makes you feel good/puts a smile on your face & takes care of anxiety/depression.

If you can control the intake of codeine & you font move onto anything harder I see nothing wrong with continuing the self medication of codeine.

I agree with both points in this post.

OP, if it works for you, then at the doses you're taking it's fine. Just watch your dose, and look after yourself.