'Over the counter' codeine addiction.

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Does anyone on here have any experience of an addiction to over the counter (purchased from a pharmacy without a script from a doctor) codeine containing medicines?

In the UK we can purchase tablets that contain codeine combined with paracetamol (acetaminophen in the US) and Ibuprofen.

Codeine as you should all know is a very addictive opiate drug.

I have been addicted to these tablets for 4 years and counting, I take anything up to 30 tablets a day, a mix mash of ibuprofen with codeine and paracetamol with codeine.

I know this is really bad for me before anyone starts telling me that, I know all the facts. It's the paracetamol and the ibuprofen that's worse for your body than the codeine, but people who are addicted tend not to let that stop them taking too much

I have posted about this on other forums but I have been met with aprehension and total lack of awareness of how my Asperger's effects my addiction, visa versa.

I first started using Nurofen Plus (ibuprofen and codeine) for period cramps, and realised soon after it made me feel calm and took away some of my anxiety. As my tolorance to it built, I found myself using more and more and then introducing Solphadine Max (paracetamol and codeine or co codamol) into the mix. I now take 4 tablets, two Nurofen Plus and two Solphadine Max at once randomly through the day.

Each tablet contains 12.4mg of codeine, so that's like 46 point something mg of codeine in each dose.

My doctor (two infact) have told me that these over the counter pills are a 'low dose' and getting off them is easy! No it isn't, they cause nasty withdrawral symptoms when they are stopped, which are simlar to heroin or morphine!!

They are 'low dose' when they're used correctly, but in someone who is addicted the dose can be so high the other ingredients in the tablets actualy kill people.

There is little support here because the addiction is not really recognised, there is no addiction treatment service for it because most of them are funded by the criminal justice services, for people abusing opiates and other drugs illegally. If I was getting the codeine or even the low 8mg dose co codamols from a street dealer, this would qualify as illegal and I could access some help!

Even then, if whoever helps me does not understand how AS fits in with this addiction, they will fail and probably do more harm than good.

I cannot access any AS services because the one in my area discharged me because my needs are too complex, and the one in the 'city' area is off limits to me because I live in the 'county' with a county postcode, even though the hospital where it is at is just a short inexpensive train ride away.

The whole referal thing is very complex, because in order to be refered to a service out of your home county, you must tick all the boxes that the local services cannot provide for, aspergers doesn't qualify because the local servces HAVE to take people with it on, dispite the fact they have neither the expertise or the funding to cope with us.

I have been discharged from the local mental health team twice because they don't understand me, they accused my husband of abusing me and causing all my problems the first time, and made me leave with a bunch of battered wives help leaflets, which I had to hide promptly because I had asked him to wait with me! That's how much they understand.

I have admitted to my addiction, it is serious, I know it is my fault, nobody forced the pills on me. However I am shocked at people's lack of concern. I've done the hardest thing by admitting I need help, but where is that help going to come from? I have faught this so many times in attempts to taper the pills off myself, but I can't, I use any old excuse to take them.

I am not just battling the codeine, I am fighting with a whole part of my personality! I can't seem to get through to people I can't just walk into any old clinic and be rid of it. I have massive verbal communication problems which make face to face discussions with 'officials' very hard for me and I need someone there to interpret for me so I don't misunderstand and they don't misunderstand me.

I can't use the phone with strangers either, because of problems with remembering things said to me and tones of voice etc. If I think someone's angry or shouting at me, I'll just put the receiver down etc.

Sorry for the long post but I'm at my wits end. This addiction is expensive, destructive, depressing and dangerous, but I can't stop.

I was on a high dose of dihydracodiene for 6 months (60mg 4 times a day) for sciatic pain in my back and on another occasion for several weeks for tooth pain (infected molar) and am well aware that they can and do affect mood and bring on a feeling of relaxation. I am also aware that they make you feel like death warmed up when you stop taking them. The temptation to use them as a mood booster is phenomenal, but it's not worth it.

I found that by disabling them as a crutch (in the same way I stopped using alcohol as a crutch back in the days when I was addicted to that) helped to change my relationship with them and to remove the psychological side of the addiction. I also found other healthier ways of feeling good (such as moderate exercise when I was well enough...).

As for physical side effects of stopping I found that weaning off them gradually (slowly reducing the dose) for a reasonable period of time helped me to lessen the physical withdrawal. I still felt like I had a really bad case of the flu with a very upset gut for a week or so and my mood was all over the place but the thing to remember is that it DOES wear off...so I just kept pushing through it.

I hope you manage to resolve your addiction.

A few years ago I was prescribed a benzodiazepine for anxiety (clonazepam) and even though it was completely legal, I became addicted to the pills and was taking far too much of it. I felt sort of the same way, it couldn't be a problem because it was legally prescribed to me, but I found I couldn't stop them on my own.

Have you ever thought about checking out a group such as NA? I know it seems like a crazy big jump to go from an over the counter pill to NA, but they will never ask you what you're addicted to, you're not expected to tell anyone your drug of choice. You're actually not supposed to mention individual drugs at all. I felt out of place when I went because I wasn't doing "hard" drugs or anything, but NA has a range of experiences from street drugs all the way to legal drugs.

If there's no other support for you anywhere, it could be an option.

I used NA to help me get off the pills (and stop abusing alcohol at the same time), and even though the large groups of people and social interaction were difficult for me, they seemed to be a pretty accepting bunch. I go occasionally to an NA or AA meeting when I feel like I might start back up again.

I'm surprised that the level of acetaminophen you are taking hasn't damaged your liver, as anything above 4 g acetaminophen/day can do damage to your liver. I'm guessing you're taking almost twice the maximal recommended dose. Get a liver function test done. I was addicted to both benzodiazepines (clonazepam) and oxycodone (much stronger than codeine). I was originally prescribed clonazepam for anxiety issues but I built tolerance to it and was getting major headaches and found out that the addition of narcotics to the clonazepam was a much more effective anti-anxiety combination but even this only lasted for a few years. Eventually tolerance to both drugs occurred and side-effects (constipation) did me in and I eventually quit both with some help. You might need to get some help to quit.

Yeah, and you could also ask a doctor about N-Acetylcysteine, which can help protect the liver against acetaminophen/paracetamol-induced damage. It's available over-the-counter in the USA, but it's what hospitals use when people show up with acetaminophen overdose (if you didn't already know all that).

thanks everyone for the replies, this is the best response I have got so far

It's horrible being in this place, but I am determined to stop, I just need some help with it from someone who understands I have Aspergers as well and the addiction is physical AND mental, because of my obsessive streak.

I think I will push to be put on a substitute, then have someone else help me cut that back, because buying the pills is becoming a joke now. The pharmacists in my town all know me when I 'do the rounds', they know I use it for 'longer than three days' and are always sniping at me asking me why etc etc.

Some have confonted me (BAD idea because my reaction to confrontation is aggression and rudeness) when they have refused to sell to me lol.

I have been doing it since 2008, and I feel since then I have progressed in some ways, and slipped right back in others, it's just how it goes for me.

Also thanks Apple_In_My_Eye, I have not heard of N-Acetylcysteine, but it might be worth finding out about it at least, perhaps my doctor can give me that if he refuses to support me to get off the codiene. I am really angry with the doctors because I have told two now and they are just not concerned.

People with this addiction often take the lethal dose of paracetamol ever day! I try to be careful and alternate it, but it is still awful for my body, probably worse than all the whiskey I used to drink lol. I had to have a liver function test back then because I was drinking and doing codeine, but still they didn't seem concerned. I told them why I was doing it, lack of support for my AS, but I just got offered a box of prozac, that's it. Not taking MORE drugs on top of my cocktail lol.

I follow the same patten as anyone addicted to codeine, AS or not, I started using these meds for pain, then found they did other nice things to me apart from releive pain. Then I took them when I was not in pain and took more and more to get the same effect, classic.

I associate codeine with the things I do in my life now, listening to music, playing guitar, drawing, playing sims 3, browsing the web, all are fueled by this horrible little devil, because without it, I feel I can't function on a level anymore.

I have direct experience, I used codeine from OTCs around 5 years ago but only for around a year. I was never a heavy user, I started out experimenting and working my way up in doses, up to around 350mg single doses (using CWE, see below), 1-3 times a week and after a bit I reduced it down and settled on about 120-150mg 3-4x a week for a period of 6 months or so. In my case I knew what I was doing from the start (I didn't get them for pain, I got them to experiment with) so I always kept myself in check in terms of addiction and found it pretty easy to wean myself off

If you continue using for much longer, I strongly advise you learn how to do cold-water extraction (CWE), PM me if you want detailed step-by-step instructions. At the very least, get milk thistle extract to help protect your liver (you can find it at a health food store). N-Acetylcysteine is effective but it's generally administered by injection, taking it orally (it's also sold as supplement) doesn't work anywhere near as well in terms of liver protection. Milk thistle is better.

You say you take them randomly throughout the day. Re-dosing a lot is not a good idea and gives you much weaker effects, that is probably why you have to take so many (30 tablets a day is 372mg). Sorry if I misread your post but you're taking 4 at a time and up to 30/day right? So you're dosing around 7 times a day.

If you CWE (cold-water extract, this eliminates ~90% of the APAP or ibuprofen, etc and leaves you with a water solution) the codeine you can take much higher single doses and would probably be better off taking 80-120mg 1-2 times a day rather than 46mg 7 times a day.

If you want to end your addiction fast then set aside up to a month (2 weeks minimum) where you have basically no responsibilities, or the minimum possible. You will likely need the help of family and/or friends. You can go cold-turkey or wean yourself down first. Try weaning first - in your case, if you're using 30/day, reduce it by 3 a day for 10 days (for example). It's also a good idea to dissociate using it from activities, so take each dose as if it was a medicine, at set times of the day (equally spaced). If you start getting withdrawal during the 10 days, then go cold-turkey right away (trust me).

Here is how it works, in my own personal experience (with something much stronger than codeine). Everyone is different of course, but the general timeline of withdrawal seems to be pretty consistent with what I've read about others experiences. The symptoms vary from person to person but most of them are pretty consistent.
If you wean, you shouldn't get withdrawal until you stop completely. You may however, miss the euphoric effects and I've always found it better to stop clean (completely).
Once you stop clean:
Day 1 - nothing except a mild uneasiness. You might miss the effects. Your routine will likely be messed up.
Day 2 - transient withdrawal symptoms start, in my experience it happens as "waves" lasting around 20 minutes, where I go from feeling fine to complete crushing depression. I have to remind myself "wait, I felt fine 10 mins ago, and this will past in another 10 mins, don't worry it's just the withdrawal".
Day 3 - it gets worse. in addition to "waves", baseline anxiety levels start to increase, with spikes throughout the day. sleeping starts getting difficult. mood swings.
Days 4 & 5 - the Abyss (my metaphor). One or more of the following: very mild "psychosis" (thinking gets "weird"), fluctuating moderate to intense anxiety (w/ mild tachycardia), cold sweats, insomnia, moderate to extreme fatigue, akathisia ("inner unrest"), "it's the end of the world" type depression. Bouts of crying for no reason.
Day 6 - it starts getting better, feels more like day 3, though there may still be spikes of anxiety throughout the day and some of the above symptoms (just less severe).
Day 7 - much better, compared to days 4&5 you are relieved that this feels like day 3.
Days 8 & 9 - some anxiety, fatigue and mild insomnia, similar to day 2 but no more waves, just a general mild-to-moderate malaise.
Days 9-14 - you start to wonder how you ever got addicted in the first place. Most, if not all, withdrawal symptoms disappear by day 14.
Days 14-30 - any lingering symptoms disappear by day 25-30.

Worst-case scenario is 30 days, best-case is 12-21 days.

I've never been addicted to or used narcotics for more than 6 months at a time and the above was roughly what it was like to withdraw from 25g/day of kratom.

Kratom is an opiate plant (legal and cheap too - if you want to switch to something else instead of quitting just yet then you might want to look into it), with effects roughly equivalent to oxycodone (I've only ever had oxycodone for around a week when it was prescribed). Normal doses of kratom are 2-3g, around 2-3 times day but last August-September I got a really bad virus infection and I basically took it constantly for 4 weeks (I mean, *bad* virus, I lost my voice after 1 week, was in constant pain, couldn't sleep or eat, etc). I reduced my usage somewhat but ended up addicted until the start of November, where I quit cold turkey.

For some perspective, 25g is 50 capsules. 2 capsules is roughly the same as 5mg oxycodone (or 50mg codeine). By time I stopped I was taking 15-20 capsules at a time. So, even though you've been taking codeine for 4 years, your total daily dose isn't that high. If you are 'stable' taking ~370mg of codeine a day, you should have a much easier time, especially if you wean first.

I hope my above description of withdrawal doesn't scare you, it's really not as bad as it might sound. I've been through withdrawal, albeit not as bad I just described, around 4-5 times last year. Before the virus episode I had a wisdom tooth coming up which resulted in me taking kratom at high doses (the pain was excruciating) for about 2 weeks, then stopping when the pain went away, then taking it again when it came back, etc.. At worst it's like a bad flu. Try and sleep as much as possible and when you're awake watch TV (comedy especially) or something to distract yourself from the symptoms. Cannabis helps a fair bit too, though I had none at all during the above episode. Get some OTC sedatives for the insomnia as well.

The most difficult thing might be the force-of-habit, especially if you've been at it for 4 years. It's good to find a positive habit to take it's place.

Sorry if that's an information overload, I'm a drug geek.

I just read the last part of your original post (sorry, I skimmed it the first time and I was responding to both posts at the same time), the tone of what I wrote above is based more on the last post, I didn't realize you had already sought treatment. If you really are at your wits end, then your best option is to explain your situation in detail to someone close (have you discussed it with your husband?) and set a timeline for quitting (30 days is good).

I'm not sure how else I can help, if I don't hit "submit" I'll be here for hours but there isn't much else I can say without knowing specifics.

Feel free to PM me if you want any help or more info.