Opinions - Codeine in Canada: What's the point?

[100mg Methylphenidate]

First off. This thread isn't about cold water extractions or taking extremely dangerous doses to get a little high. I'm wondering why it's illegal to have any other preparation besides 8mg of codeine mixed with 500mg acetaminophen mixed in a pill in canada. They also have caffeine right? This thread also is talking about using the medication AS directed.

This means no more than two tablets every 4-6 hours and no more than eight in a day, correct?

What benefit would anybody have at all from adding such a small amount of codeine? I know the drugs are supposed to have a synergistic effect for headaches and such, but only 16mg of codeine every 4-6 hours?

And about 8-12% of codeine is metabolized to morphine right? So we'll just say 10% to make things simple. That's only 1.6mg of morphine. Orally!

You'd be better off just taking an aspirin and two tylenol than throwing the codeine in there.

Swim personally doesn't do cold water extractions with much more acetaminophen than he would be willing to take normally. So pills with 8mg of codeine would be absolutely useless to him. And I imagine their safety profile makes them undesirable for the other non-ignorant/cautious/caring about life opiate abusers out there too.

So all in all, the drug isn't really going to do anything special for pain as prescribed. And the only way people are going to abuse it will involve people risking their lives and dying. Why do they leave it legal then if better pain preparations aren't? Is it just some sick joke to encourage APAP overdoses or what?

[apiffini]

you may think 8mg isn't a lot but when its used for medicinal purposes it can be very effective. Swim has used it for headaches and it is much better than normal aspirin or tylenol. It's for pain basically.

[honourableone]

I believe that any medicines have to be approved for use (when I say "medicines" i mean specific doses as well as combinations of different drugs), and the 8mg with APAP (paracetamol / acetaminophen) are the only ones approved. This is probably because higher doses could be seen to have recreational potential.

In England there are 12.8mg codeine tablets with 500mg of APAP available, but there are also codeine preparations available with ibuprofen (which can be taken at the same time as paracetamol), so if the same is available in Canada this could be a way of increasing a medicinal codeine dosage.

Doses of codeine that low will have an effect on mild pain, so I can see the theoretical point here, but there are reports that pills combining APAP with small amounts of codeine are no more effective than if just the APAP was taken. This is very interesting, because there obviously isn't an issue with higher doses, and the two drugs work in entirely different ways.

If you aren't convinced that such low doses wouldn't be beneficial, bare in mind that a lot of the rules concerning legally bought pharmaceuticals don't seem to make sense. Preparations are on sale that have been shown to have no benefit in aiding the problem they were intended for (for example throat sweets containing nothing but antibacterial agents), and from SWIM's experience it seems that in England it is illegal to buy two boxes that each contain 12 co-codamols (an APAP and codeine preparation), but perfectly legal to buy one box that contains 36. Madness.

EDIT: I think that the caffeine is present to increase absorption of the APAP, which is why it is often sold in preparations specifically claiming to be "fast acting".

[100mg Methylphenidate]

Swim suffers from back and leg pain on a near daily basis. He can't really walk for more than an hour without sharp pain in his knees and lower/middle back.

Depending on the severity of it, he needs 5-20mg of hydrocodone at least and 1000mg APAP to get rid of it. Swim would probably say his pain can be anywhere between a 4 and a 9 on a 10 point scale. 9 only after bending over a lot or extended standing for hours.

Swim is 'opiate naive.'

I was also wondering, the OTC Canadian preperations have caffeine in them correct? Caffeine by itself can significantly reduce headaches. So is there a real difference for swiy if he/she tries the caffeine/tylenol mix versus the caffeine/tylenol/codeine mix?

[100mg Methylphenidate]

No. Caffeine wouldn't do that. Caffeine would probably act faster(I've read it can, and felt it act in 15-30 minutes) than APAP which might take an hour or so. Caffeine is also GREAT for headaches. And I've read it can make APAP 50% more effective in stopping them than APAP by itself.

And yeah, it's funny that the "nasal decongestant" phenylephrine is on the market to replace pseudoephedrine, even though there are studies saying it doesn't work any better than a placebo. And the only thing suggesting it works period as far as I know, is some 70's study suggesting it worked. And the DEA stood by it blindly.

I've actually read a story where a father bought sudafed for himself on a regular basis, and he got his house raided and charged and everything for buying an extra pack to give to his son while he went to summer camp. The pharmacist at walgreens here always acts weird when swim tries to buy pseudophederine for his allergies. It's dumb as hell. And it happened about an hour from where I live.

Just another reason for me to question the efficacy of these codeine preparations...

[honourableone]

Thats an interesting story, they actually charged him for manufacture?

The caffeine containing pills are loosely marketed as making the APAP more efficient / increasing absorption time, maybe that's just more evidence of how the mass market pharmacies are unreliable. APAP is often taken for cold and flu symptoms, and the caffeine would help there simply for it's stimulant properties. I didn't know that caffeine was so effective against headaches, though overuse can certainly cause them.

[100mg Methylphenidate]

No, they charged him for some sort of small felony or big misdemeanor and he either paid a fine or went to jail for a few months and ruined his clean record. I don't exactly remember or feel like looking it up at the moment. The police were very "Ignorance of the law isn't an excuse. Even though he wasn't making meth he still broke the law blah blah blah what we did is for the good of everybody."

[trannyboy]

This is available to treat minor pain. They add the acetaminophen or acetylsalicycle (ASA) to discourage casual abuse and caffine to prevent cold water extraction tricks. The additives do provide a synergist effect as well. Health Canada isn't looking to help people get high or cause injury. They are just trying to treat minor pain without a prescription. I understand it is ineffective for you but it isn't for everyone and effect is largely dependant on the pain levels. If you are in enough pain that you need larger doses or different medication it is expected that you see a doctor to be assessed and treated appropriately. Having this medication available over the counter is a good a thing even if you don't think so.

The caffine is also to offset the sedation that can occur with codeine. As for the case you mentioned that guy should have had a better lawyer. At least in Canada it isn't illegal for a father to give his child medications. I would have fought that charge tooth and nail but that is me. I know what you mean about strange looks from pharmacists. When I buy medications to restock my first aid kit, I usually get some strange looks but I have never been refused. The worst that happened was the pharmacist asked to see my ID and that only happened once and that was in Quebec. In Ontario I have never had anyone so much as bat an eye.

trannyboy

[100mg Methylphenidate]

Well. I didn't mean I think it should be illegal. I think all drugs should be legal. But from swim's experience, he doesn't find a low dose of codeine much if any more helpful than aspirin. Which is what I'm getting at. Is 16mg of codeine actually more effective for anything than 1000mg of aspirin? This is ignoring the fact that you could take the tylenol 1's and use aspirin too, because at least to me, it seems probable that most people just buy one pain medication when they need pain relief, not two or three.

I guess the snergenic effects could do something for somebody with a headache or a minor pain, but in the eyes of these anti-drug people, is it worth legalizing 8-16mg of codeine per dose over?

People in such a small amount of pain would probably live just like everybody else in America without the pain relief of such a small amount of opiates correct? But I'm sure a lot of dumbasses die because they take so much APAP to get high. So to an anti-drug person, we need to get these drugs restricted like they're doing with a lot of DXM syrups. But the anti-drug people are just keeping doses low instead, increasing death by dumbasses(DBD) and not actually accomplishing much if anything pain relief wise. So it's sort of like how regular doses of DXM in america aren't that effective against coughs, but we don't want anybody getting high off it so we leave doses low, and add other shit so people who take more damage their bodies to get more effect or die to get high. So we have a useless drug on the market, for the sole purpose of letting people get a placebo effect and letting DBD happen.

Again, I don't personally think this drug or any other drug should be illegal. I don't know if you guys completely got my point or not, maybe I'm just assuming you didn't. But I am assuming 16mg of codeine isn't a lot. That's got to be like taking 1mg of hydrocodone which swim has a lot of experience with, and that wouldn't do ANYTHING for him. Maybe a placebo.

As a single preparation, wouldn't a 500mg APAP/500mg Aspirin (midol right?) preparation be more effective with a cup of tea than just throwing a little TINY bit of codeine with some APAP? I'm sorry.

Baiscally. Why have codeine legal if you're not going to make it completely legal? People are just going to do idiotic shit and die from it, and it's not going to do much more than give a placebo effect and maybe give a SLIGHT boost to somebody in minor pain, and if their pain is that minor, it's probably not significant enough to warrant all the problems it's going to cause with dumbasses young and old popping twenty at a time. From the point of view of a Christian conservative politician who is very anti-drug and about 'controlling' the problem, wouldn't it just make more sense to direct somebody to a doctor for more pain relief than leaving such useless amounts legal?

Sorry if I repeated myself or ranted, which I probably did. It's been a long day and I'm tired as hell. About to head to bed.

[trannyboy]

Incidentally you could take up to 32mg of codeine and still follow the labels by mixing 2 tabs of tylenol 1 and 2 tabs of Aspirin with codeine and that would take care of the majority of minor pains on multiple levels. Again I think you aren't hearing us because I know a lot of opiate niave people who would find 2 tabs of tylenol 1s or 2 tabs of 222s for a sprained ankle to be perfectly sufficent. You are right though that some people aren't going to be helped much with that small a dose of codeine but the point is you should see a doctor if in that much pain.

I also hear your point about those who will abuse tylenol 1s or the like. It is dangerous and I don't really know what to say except dumbasses looking to get high will find a way no matter what we do to try and stop them. That is why we have idiots sniffing glue, spray paint and cleaning fluids. If they regulate tylenol 1s or the like then they will just find other ways to get high even if it means killing themself. Also regulating tylenol 1 or the like will just mean that we will have people that it works for flooding emergency rooms to get it. At least now people have access to a minor opiate pain killer without being hassled that will work in most cases. As for legalizing higher amounts with additives or lower amounts without additives, we will still have idiots killing themselves to get high.

I have never quite understood using them to get high because of the large volume of additives. SWIM just asks their doctor for a script for 30mg pure codeine to have around the house and adds their own synthergist based on their type of pain at the time but that is SWIM. I don't really see a better solution then either legalizing it all or the system we have. Personally I am for legalization but I don't see that happening anytime soon.

I can hear how frustrated you are. Sorry I don't have anything better to say. Maybe you can think about putting your energy into trying to change the system instead of preaching to the choir, no offense intended.

trannyboy

[hamsterdam]

yeah.. regulating it is pointless when doctors give it out even if they think you're abusing it. It just forces people to put an unnecessary burden on the already overstrained health care industry.

[HorseBucket]

Swims reading the book Oxy by Otto Snow and the author claims that the main reason they put acetaminophen or aspirin into pharmaceutical opiates like Oxycontin, Vicodin etc. is to stop people abusing them. They'd rather people suffer severe liver damage than get addicted to opiates. Wheres the logic in that? Swim would take opiate addiction over liver damage any day.

[nevelshaze]

lol , sprinkle rat poison over the rest of billys candy, id rather he die then get a sugar rush.

[HorseBucket]

Originally Posted by nevelshaze

lol , sprinkle rat poison over the rest of billys candy, id rather he die then get a sugar rush.

Haha the analogy Otto Snow gives is putting rat poison in the cookie jar then telling your kids not to eat too many cookies.

[nevelshaze]

ahahaha close enough

[trannyboy]

I don't agree with the anology. First off acetaminophen or ASA isn't all that dangerous especially in reasonable amounts; rat poison is dangerous in any amount. Second, health canada doesn't work off the assumption that people will abuse it. They assume people will be intelligent and have some sense of self preservation thus not abuse something. Admittedly abusers will abuse it and hurt themself whether by acetaminophen or overdose of codeine. Also they don`t just put it in to stop people from abusing it, it does have a synergist effect. Now I don`t agree with the regulation that is in place. I think someone should be able to buy pure codeine just like they can buy codeine with acetaminophen; mainly because for some both acetaminophen or ASA is dangerous.

However the important thing to remember about regulation is that it has a lot to do with profits. For instance SWIM is incrediably unwell and have been most of their life. There are medications that would help SWIM but because they are either not recognized as conventional treatment, unpatentable, unprofitable or another drug that works for some is available with a higher profit margin we don`t have any company that will push health canada to make it available. As a result SWIM has to either import it if it is available in another country, use something that doesn`t work, pay extra or suffer without because health canada won`t allow people to assume risk. What I don`t understand is why can`t SWIM assume the risk? Why can they put SWIM in jail just because SWIM is sick and needs better or different medication? I can think of at least 5 medications offhand that would make SWIM's life much better but SWIM can't get them without going to jail.

trannyboy