A WEST CORK GP is calling for the abolition of over-the-counter access to codeine medications amid concerns that stockpiling is leading to devastating addictions.
Bantry-based GP Paul O’Sullivan said pharmacists and GPs are currently liaising with one another to detect suspicious behaviour linked to medication stockpiling.
Dr O’Sullivan opened up about how there are people leaving rural areas in search of pharmacies further afield in a bid to satisfy their addictions.
Codeine is an ingredient in many popular over-the-counter painkillers such as Solpadeine. It is often used in combination with other non-prescription painkillers such as paracetamol, ibuprofen, or Nurofen Plus.
“In a small country town, people notice very quickly when you are visiting a pharmacy more often than you should be,” Dr O’Sullivan said. “This is why people are travelling further afield to get their supply. Unfortunately, we have had people travel considerable distances to different towns.
“Tablets contain a low amount of codeine but if you purchase an amount of tablets you can build up a considerable dose that gives you a significant high. Codeine is an opioid that can be very addictive.
“While heroin is a far stronger opioid, codeine can be equally as addictive —
people can have extreme side effects and withdrawals from codeine.
“Obviously it doesn’t have the dangers that you have with heroin. However, those finding themselves taking codeine a few times a day don’t realise just how difficult it can get. You cannot account for how many people will go to different shops to get 20 or 30 codeine tablets a day. These people run the risk of life-threatening side effects, given that some of the codeine tablets contain paracetamol. If you take more than eight paracetamol a day the risks can include severe liver problems including liver failure.”
The GP described codeine dependence as an epidemic.
“This is a hidden epidemic and a hidden drug of abuse. An addiction like this is very hard to spot until something significant happens such as the person running out of their supply. This is when it becomes a problem.”
The medication becomes even more dangerous when mixed with alcohol.
“It can become quite a potent mix. A tablet or two leads to a situation where the person can no longer function without the medication. They are trapped in a spiral where they have to continue using the same way a heroin user or very strong opioid user would. The body becomes used to the amount that they are taking very quickly, especially with Codeine. One needs a very high allowance to maintain that fix or high.” He said that pharmacists have also become extremely skilled at identifying signs of addiction.
“The pharmacists have a good eye for a situation that’s not quite right.
“They will ring us from the locality or outside if they spot suspicious behaviour. Good informal information sharing is very useful in terms of identifying anything that might be problematic.”
The GP is calling for the restriction of codeine to those with prescriptions.
“I feel it would be more useful to have codeine containing tablets available with a prescription when taking into account the problem that the stockpiling of over-the-counter medication has become.”