The researchers say more research is needed on how many misuse OTC drugs
The dangers of becoming addicted to over-the-counter (OTC) medicines are going unrecognised, doctors warn.
In the British Medical Journal, Chris Ford and Beth Good say they have seen three patients addicted to drugs containing codeine in recent months.
All began using the drug as recommended, but their use grew.
The drug companies' trade association said there was guidance in packs, but researchers said the public needed to be more aware of the addiction risks.
These medicines are already strictly regulated - they are only available from pharmacists and have clear instructions on how to use the medicine and when not to use the medicine
Helen Darracott, Pharmaceutical Association of Great Britain
All three of the patients seen by the doctors had been taking Nurofen Plus, a combination of codeine phosphate - which is an opiate - and ibuprofen.
They all had gastrointestinal bleeding, a side effect of excessive ibuprofen use.
One of the patients was taking 30 tablets a day - compared to the recommended maximum dose of six.
'Tip of the iceberg'
Alone, codeine phosphate is only available on prescription. But it has been available OTC in low doses and in combination with aspirin, paracetamol, or ibuprofen for many years.
The doctors say that the Over Count website highlights shows the most common addiction is to the OTC drug Solpadeine - a combination of paracetamol and codeine. The website suggests more than 4,000 people registered there currently have this problem.
But Dr Ford told the BBC News website she did not think the drugs were unsafe, or that they should be banned.
"Thousands and thousands of people take these drugs and don't have any problems. It's a very small minority who do.
"But our anxiety is that it's a problem which is not being picked up by the public or doctors, and that we're just seeing the tip of the iceberg."
Dr Ford added: "There are lots of websites where patients are talking about their addictions.
"But we have no idea how big the problem is because there has been no research to quantify it."
She added: "We need to get the evidence and also raise awareness in the general population and in the healthcare population."
'Thousands benefit'
The company which makes Nurofen Plus, Reckitt Benckiser said Nurofen Plus was sold under strict guidelines and was only available in 32 pill packs.
Packs also say patients should seek medical advice if they need to take the drug for longer than three days.
Dr Phil Berry, Reckitt Benckiser's global medical director, said: "There is a considerable body of scientific evidence illustrating the safety of OTC product combinations of codeine with either ibuprofen or paracetamol as long as they are used correctly for short term relief, according to the pack instructions."
A spokesman for GlaxoSmithKline, who make Solpadeine, said the company took reports of any OTC medicine misuse very seriously, but stressed it was rare.
He added: "Hundreds of thousands of people benefit from safe and effective use of Solpadeine every year.
"There are clear instructions for use on our labels, and if these are followed there is no evidence that the product will cause dependency."
Helen Darracott, of the Pharmaceutical Association of Great Britain, said: "OTC medicines which contain codeine or dihydrocodeine should be taken only to relieve symptoms of pain and only for short periods unless a doctor has advised otherwise.
"As with all medicines, people should consult their pharmacist or doctor if their symptoms persist or get worse.
"These medicines are already strictly regulated - they are only available from pharmacists and have clear instructions on how to use the medicine and when not to use the medicine."
They all had gastrointestinal bleeding, a side effect of excessive ibuprofen use.
One of the patients was taking 30 tablets a day - compared to the recommended maximum dose of six.
It's quite sad really.
To think if these people had become dependant on just the opiate part, psychologically they may need some support (they may even have to go through serious withdrawal) and there would still be the occasional problem or fatality [no system is perfect]. Still compared to the incidence of serious and simply unnecessary permanent GI bleeding and related fatalities SWIM would predict a better outcome from the selling the opiate on it's own. [?It is unlikely this hypothesis will ever be tested]
To think if these people had become dependant on just the opiate part, psychologically they may need some support (they may even have to go through serious withdrawal) and there would still be the occasional problem or fatality [no system is perfect]. Still compared to the incidence of serious and simply unnecessary permanent GI bleeding and related fatalities SWIM would predict a better outcome from the selling the opiate on it's own. [?It is unlikely this hypothesis will ever be tested]
D'you wanna know the saddest thing? I take around this amount every day and know all the dangers. When you're this hooked with no assured GP help you do risk it. My doctor/s know the score but if I went back to him and protested and virtually begged to be put on my opiate again - not a huge dose either - he'd just send me packing. Once you're an addict you're considered scum. I've a daughter who's an R.D.N., a son who's on his way to university next year studying music, and my youngest is the most confident little guy I know. Not bad for a 'opiate addicted mum' is it? These past 7 months without my opiate but on Nurofen Plus have been the worst for years. Depression, moodiness and anxiety. When I crave I self-harm as a distraction. On my daily opiate I was fine. Getting on with life. But if I was denied NP, God knows what I'd do. I'm maybe on my way to death right now. But I feel nobody cares. How do you tell your kids that? My only chance now is through an upcoming appointment with a mental health team. But if GP's don't give a shit why should they? I've tried being drug free and I just can't do it.
Itzy-Bitzy added 11 Minutes and 49 Seconds later...
Quote:
Originally Posted by tch2296
All you need to do is perform a simple cold-water extraction to get the pure codeine phosphate..PM me if you need help I have WAY too much experience.
I hope your ban wasn't because of your answer to me. Wierd thing is it would probably have advice I could have used. I'm lost, simply lost.
Last edited by Itzy-Bitzy; 25-07-2008 at 20:52.
Reason: Automerged Doublepost
D'you wanna know the saddest thing? I take around this amount every day and know all the dangers. When you're this hooked with no assured GP help you do risk it. My doctor/s know the score but if I went back to him and protested and virtually begged to be put on my opiate again - not a huge dose either - he'd just send me packing. Once you're an addict you're considered scum. I've a daughter who's an R.D.N., a son who's on his way to university next year studying music, and my youngest is the most confident little guy I know. Not bad for a 'opiate addicted mum' is it? These past 7 months without my opiate but on Nurofen Plus have been the worst for years. Depression, moodiness and anxiety. When I crave I self-harm as a distraction. On my daily opiate I was fine. Getting on with life. But if I was denied NP, God knows what I'd do. I'm maybe on my way to death right now. But I feel nobody cares. How do you tell your kids that? My only chance now is through an upcoming appointment with a mental health team. But if GP's don't give a shit why should they? I've tried being drug free and I just can't do it.
Itzy-Bitzy added 11 Minutes and 49 Seconds later...
I hope your ban wasn't because of your answer to me. Wierd thing is it would probably have advice I could have used. I'm lost, simply lost.
It's all on the here mate, I believe it's actually a sticky(on cold water extraction) or at least how it's theorictally done. SWIM is lucky enough to have a GP that DOES give a shit but knows what you mean, it took SWIM a while before SWIM found such a doctor... BTW SWIM is an RN(and if you read some of my post's about SWIM's drug life...) and is wondering what a R'D'N is(assuming that it wasnt a typo)... not being funny just wondering as SWIM would want to know
My GP doesn't give a toss that I'm on these things on a daily basis. I used to be on a strong opiate which was originally needed for severe pain problems but which ended up in addiction and I did abuse them to help with all the extra shit in life. Psychologically I was more dependant on them and the buzz was no longer physically there but that didn't matter to me, as I still saw it as my major tool of functioning and reason to cope.I was on a relatively daily small dose of opiate, but the tendency to abuse had left as I knew I was getting them every day anyhow, and that was the case for many years. I overcome the health issues thanks to a second opinion gynaecologist agreeing to a hysterectomy, despite being in my twenties. But I now needed this drug to function. Which I did and seemed to improve my life. My children went on to take what they wanted from life and I helped them through all the schooling, education and social development that was needed to make them respectable young adults. I loved my children dearly, still do, but if I'm honest, if it wasn't for the fact that I knew I had my opiates, I probably wouldn't have got out of bed. Maybe I have an addictive nature. Who knows. My doctor doesn't seem to ask himself that.Around two years ago his surgery took on new doctors, and all of a sudden my 'drug problem' was brought to the forefront and despite telling him that I didn't want a reduction, that I wasn't willling or ready to come off my stability, he still started to reduce them. Just little bits at a time. But nervous that I had no choice, to make up for my loss I tried to equivilate it by Nurofen Plus. I'm not great at judgement but I tried to make up for the amount of opiate being denied me. This gradually mounted. Twice I went to my doctor with empty packets of the stuff, telling him I didn't think the reduction was fair and that I was scared of losing my opiate altogether.He quite frankly told me that the effect would be little or not at all that my intolerence wouldn't bring on a buzz, so there was no point to taking them anymore. Despite telling him that psychological dependancy was my 'hook', I was just disregarded. Other doctors in the surgery were a bit more supportive but still went by GP's ruling. It was his surgery after all. His name that was being marred. His shame in me as a patient, no doubt. Just my life that was being distrupted.So now I'm on a co-codamol 30mg 8 times a day. I hate it, rarely take it as I prefer Nurofen Plus. Yet, it's not so strong but I'm reckoning the paracetamol will kill me if I take too much whereas the ibuprofen is a bit safer. My opiates ended was just after Xmas 2007. I cried as I took the last ever tablet. Despite this I tried my best to adapt but my safety net has gone forever. Without my opiate I can't travel, go out for the night, meet new people, start a new job ect. My husband tries his best to understand but if he's feeling edgy it's simple for him to buy a pint.So, the way I see it is this. My doctor would rather I risk abusing drugs again, not really caring that I am on 32 Nurofen Plus a day, as it makes him look triumphant in bringing me off these 'naughty' drugs after 16 years. In truth I see no future for myself. I've lost my pride, my happiness and life is seeming to throw constant little challenges and struggles at me. If it wasn't for my youngest son I'd think about seeking illegal drugs somewhere, but I'd die if that brought him shame. People are too keen to ever judge illegal drug use so as I hid my opiates from my kids, I'm hiding my Nurofen habit too. Trouble is, I'm scared for what the future holds. I can't see a drug free life for myself. Not now. Why can't people just let people be when they are settled, happy and coping?
Itzy-Bitzy added 2 Minutes and 30 Seconds later...
Sorry for my previous post not having paragraphs - it did before I posted it!
Last edited by Itzy-Bitzy; 10-07-2008 at 21:21.
Reason: Automerged Doublepost
I hope "they" don't do something stupid like make more OTC drugs require a prescription.
I remember Dr Phil (TV psych in USA) saying that he was going to crusade to make cough medicine require a prescription due to all of the DXM abuse. So now poor families without health insurance will need to pay over $100 for a bottle of Buckley's? That's a fantastic idea. I'm sure poor people will love that initiative.
24-01-2008, 16:06
Over-the-counter drug use concern
Similar Threads
Hybrid Mode
