NEWS: News.com.au - 8/01/08 'Nurofen Plus - the hidden drug scourge'

[lil angel15]

Nurofen Plus - the hidden drug scourge
By Mark Schliebs
January 08, 2008 12:00pm

BEHIND closed doors, many Australians are feeding a secret and dangerous addiction to a popular over-the-counter painkiller.

Nurofen Plus - which can be bought in packs of up to 72 tablets and which has been linked to the death of a 49-year-old woman in the UK - has become a demon for thousands of users of seeking help on online forums.

The founder of a popular Australian forum, which has seen 7000 addicts register since 2003, estimated 5 per cent of the population could be addicted to the codeine in Nurofen Plus.

A packet of 72 tablets - three times the size of the standard packet of 24 - can be bought for under $25 at pharmacies.

The forum's founder - who did not want to be named in order to protect his identity and those of people using the forum - said one of his friends had been taken to hospital several times because of ulcers caused by abuse of the drug.

“There would be people out there that have died because of the codeine,” the forum’s founder told NEWS.com.au.

“I don’t know any social circle where (addiction) isn’t happening.”

Ulcers, organ damage

He said the forum was developed after he discovered some of his friends were addicted to codeine and developed medical conditions from ibuprofen, also an ingredient in Nurofen Plus.

“People (can get) really bad ulcers… which can perforate the stomach.”

He said others had experienced kidney and liver damage because of their “secret” addictions, which he likened to the “behind-closed-doors” valium addictions of last century.

A spokeswoman for Nurofen Plus manufacturer Reckitt Benckiser today said all packaging clearly stated that no more than six tablets should be consumed within 24 hours and the drug should not be used for more than three consecutive days without advice from a doctor.

“The directions for use clearly list the conditions each product is suitable to treat, the cautions for use, the recommended dose, directions for use and when it should not be taken,” manager for medical marketing Carolyn Winkler said.

"Crisis point"

Last week, a mother who said she had been taking high doses of other drugs like panadeine forte and stress-reducing benzodiazepines, posted a comment on the Nurofen Plus addicts' forum describing how she had reached “crisis point”.

“My doctor is sending me to a psychiatric clinic that deals with the addiction (not sure how yet) as well as medication for depression and anxiety and counselling,” she said.

“I have to stop permanently this time, I can't handle it anymore.”

Another forum user, a man in his early 20s, posted a comment on Sunday about consuming 72 Nurofen Plus tablets on some days.

“I know I need to quit but that’s up to me to make the move,” he said in the post.

“I guess codeine addiction is actually kinda lonely and just having people to talk to would help.”

Significant problem

In the latest edition of the Medical Journal of Australia, Dr Martin Dutch of The Angliss Hospital in Melbourne wrote that misuse of Nurofen Plus was a “significant” problem.

“Over a six-month period, two patients presented (themselves) to a community hospital emergency department with perforated gastric ulcers as the result of recreational misuse of over-the-counter ibuprofen–codeine preparations,” Dr Dutch said.

“Misuse of these medications appears to be an emerging cause of significant morbidity in patients with codeine addiction.”

Although only a small number of codeine-related deaths have been reported, a recent case gained worldwide attention into the dangers of being addicted to the painkiller.

Mother dies

Last month, a London coroner was told that 49-year-old Linda Docherty took as many as 64 Nurofen Plus tablets a day before dying last March.

The coroner found Ms Docherty died “by reason of an addiction to over-the-counter medication”.
In an article in the January 2005 edition of the Journal of the Royal Society of Medicine, doctors at the UK’s Taunton and Somerset Hospital said addictions to Nurofen Plus could easily go undiagnosed.

Doctors Paul Lambert and Colin Close said in their paper - Life-threatening hypokalaemia from abuse of Nurofen Plus that a 45-year-old’s addiction was not discovered until months after her first visit to their hospital.

“From another source we learned that her flat was littered with empty Nurofen Plus packets, and she later described regularly consuming 28 grams a day of ibuprofen,” the doctors said.

“We believe this is an important issue to raise, because in the present case… the ibuprofen was an over-the-counter preparation.

“Abuse of such agents can easily escape notice.”

News.com.au

 

[lil angel15]

Could this be the beginning of the end for OTC codeine containing products?????

 

[hoptis]

I'm assuming this is the forum being discussed:

http://mc2.vicnet.net.au/home/cahf/index.html

Has been mentioned here before and is a great resource for those struggling with codeine/N+ habits.

 

[Splatt]

so she died off ibuprofen?

 

[Numeron]

“From another source we learned that her flat was littered with empty Nurofen Plus packets, and she later described regularly consuming 28 grams a day of ibuprofen,” the doctors said.

looks like it... thats quite a lot of ibuprofin too...

remember to CWE people - saftey first

 

[Splatt]

I didnt sign up to that site but wonder if in the forum it tells people how to CWE that didnt even know about it

 

[Spikester]

So nurofen plus seem to be sold just in the normal aisles now in my local pharmacy, and not over the counter. How long has it been like this? I thought all codiene containing medicins would be OTC?

 

[lil angel15]

I'm pretty sure you will find that's just ibuprofen only Nurofen products rather than the codeine containing Nurofen Plus. Nurofen Plus are pharmacy medicine only AFAIK.

 

[DoctorShop]

Does anyone know if those people are aware of the CWE method on that forum? I find it hard to believe that these people haven't at least done a little bit of research on the subject. Who just goes ahead and eats 72 N+'s? Surely they are aware of the repercussions?

 

[Splatt]

lil: ur corrent u have to be in a pharmacy (and not on shelves, its behind counter) to buy N+, in QLD its upto the chemist to register and label it with your license and name, depending on pack size. same with any codeine product..

funny how pseudo is very watched, but more dangerous synephrine is totally legal even to buy in supermarkets or gas stations. and phenylephrine (synephrine) can still be used to make speed, just very very very low quality impure crap.

 

[hoptis]

Does anyone know if those people are aware of the CWE method on that forum? I find it hard to believe that these people haven't at least done a little bit of research on the subject. Who just goes ahead and eats 72 N+'s? Surely they are aware of the repercussions?

It's been mentioned here before that CWE is almost never mentioned on that forum, I don't know what the people running it would think about CWE though I've never seen them edit or remove posts that instruct on how to do it. Most people on those forums would see CWE as "druggy" thing I'd imagine and shy away from it, even though it might save their lives.

 

[the_ketaman]

As soon as the media finds out about CWE its going to be on, it will be seen as manufacture and there will be either new laws for meds containing codeine OR they will make it somehow impossible for people to extract the codeine out of the tablets.

I think its unlikely that codeine addiction is in all circles, Im the only person I know of in my area that even knows you can get high off codeine.

 

[AcidRain]

Hi guys,

I am the unnamed man in his early 20's referred to in this article.

I have been "selectively quoted" by this journalist, in order to misrepresent me and support their story's view that codeine use is dangerous.
They left out the fact that I perform cold water extractions on those 72 pills... reducing my ibuprofen intake from 14,400mg to approximately 1000mg, which is the equivalent of about 5 pills straight from the box.

 

[JimiHawK*]

i LOVE how the article implied codeine killed the lady and is responsible for all the side effects


Im praying to god OTC codeine isnt banned in NZ D:

 

[MattPsy]

lil: ur corrent u have to be in a pharmacy (and not on shelves, its behind counter) to buy N+, in QLD its upto the chemist to register and label it with your license and name, depending on pack size. same with any codeine product..

funny how pseudo is very watched, but more dangerous synephrine is totally legal even to buy in supermarkets or gas stations. and phenylephrine (synephrine) can still be used to make speed, just very very very low quality impure crap.

Eh, wtf how?
There's no a-Me chain... and the aromatic ring has a hydroxyl group on it.
Doesn't make any sense at all.
Sure you could still do a HI/P reduction on it, but all you'd get is N-methyl-3-OH-PEA, which isn't going to be speedy at all :/ .

 

[peaked]

lil: ur corrent u have to be in a pharmacy (and not on shelves, its behind counter) to buy N+

I've noticed at a few of the large pharmacies here in SA that the N+ and panadeine/generic brands are on the shelf, but only in 24 box quantities. All higher amounts are kept behind the counter.

 

[Spikester]

Yep in central Sydney here, boxes of 12 are available on the shelf...buying two didn't even raise an eyelid to the check out girl.

 

[AcidRain]

Waste of an article really... Why not report on something useful?
if they aint gonna ban DXM containing cough syrup, theres no way theyre gonna ban nurofen plus.

 

[lil angel15]

Codeine painkillers spark health, addiction fears
By Ashley Hall

Some doctors are worried that the overuse of the new combination of codeine and ibuprofen, found in painkillers such as Nurofen Plus, could be causing health problems.

Many Australians would remember an earlier well-worn method of easing a headache - a cup of tea, a Bex and a good lie down - until doctors worked out that the analgesic Bex powder was addictive and could cause serious kidney disease.

On its website, the company that makes Nurofen boasts that it has the fastest-growing analgesic brand in the world and is the leading brand in Australia, New Zealand and the UK.

It has become popular because its main ingredient, ibuprofen, blocks the production of the chemicals that cause pain, swelling and inflammation.

Nurofen Plus is a heavier duty product. It not only contains ibuprofen, but codeine as well.

Pharmacy Guild of Australia president Kos Sclavos says that codeine is a normal ingredient in many analgesia products which relieves everyday ailments such as headaches, migraines, toothaches, sore throats and period pain.

But the problem is that the painkiller can be addictive, and when used in large amounts or for a long time, it can have nasty side effects including liver damage and heart problems.


Risk of addiction

In the latest edition of the Medical Journal of Australia, former Melbourne Angliss Hospital emergency registrar Dr Martin Dutch writes about two patients with perforated gastric ulcers after misusing the drug.

The moderator of an online forum for people addicted to codeine says the problems do not stop there.

He has asked for his identity to be protected, so will be referred to as Geoff.

"I've seen... relationship breakdowns, [people] losing their children, losing their partners, losing their jobs," he said.

"We know of at least one suicide that is at least partially related to codeine addiction."

In the four years Geoff has been running the forum, he has been contacted by about 4,000 Australians who are misusing codeine.

Professor Gordian Fulde is the emergency department director at St Vincent's Hospital in Sydney.

"Only somebody who knows the patient well will pick it," he said.

"The patient may not even pick it. They will just think, 'oh look, I am in pain. So I need another painkiller'. But it actually isn't the pain any more which is the main driver."

At the moment, products containing codeine are available over the counter at pharmacies.

Mr Sclavos says it is a difficult balancing act to make sure the drug is accessible to those who need it, without making it too easy to get for those who might misuse it.

"Currently, we are quite comfortable with the level of care and protection that consumers have with these range of products," he said.

"Although, like any products, whether they are a prescription product, illicit products even, or pharmacy products, there are those who abuse these products."

Geoff, on the other hand, says pharmacists need to be especially vigilant of people buying large quantities of the drug.

ABC Online

 

[DoctorShop]

Sorry for a somewhat newb question but I'm confused.

But the problem is that the painkiller can be addictive, and when used in large amounts or for a long time, it can have nasty side effects including liver damage and heart problems.

What are they saying here? It's not clear. Ibuprofen can cause stomach ulcers/liver damage, but I've always been under the impression that codeine/opiates in general do not cause problems for the liver.