From 1st February 2018 you will no longer be able to buy codeine containing medications over-the-counter at pharmacies. If you have strong or chronic pain and need medication as part of your pain management strategy, you will need to see your general practitioner for a prescription, who may recommend other options including a referral to a pain specialist for or pain management clinic, such as Capital Pain and Rehabilitation Clinic for an opinion and other options.
The addition of codeine in over-the-counter medications actually offers very little benefit over the medications without it. Unfortunately codeine which is an opioid drug is highly addictive, and can and has led to opioid tolerance, dependence, addiction, poisoning, and even death. Side effects include headache, drowsiness, dizziness, difficulty in breathing, nausea, constipation, and increased likelihood for falls particularly in the elderly. In fact dependence on this drug creeps up on people very easily, with higher and higher doses being needed to get relief from the same symptoms. Also severe withdrawal symptoms can result when you stop taking codeine and those symptoms often mimic the pain that the drug was originally being used to treat. We then mistakenly think we need the medication to control our pain. We see this particularly with headache.
The other big problem that happens if you take more of the recommended dose of over-the-counter drugs that contain codeine is that serious harm can occur. For instance, with paracetamol you can end up with liver damage, and with ibuprofen this can result in internal bleeding, kidney failure and heart attack. Medical evidence also finds that simple paracetamol and/or ibuprofen or in a combination is surprisingly effective for many acute and persistent pain problems.
Sometimes patients tell us that they know they are dependent or addicted to codeine and feel embarrassed that this has happened to them, but they just can’t seem to stop taking it. Our answer to this is to reassure that it’s going to be okay, explain why this commonly happens, and that rather than beating themselves up, it’s best to look at a plan of action that puts them back in control. This may include helping patients through the withdrawal period, and providing education about effective pain management strategies such as relaxation, mindfulness, exercising, and stress reduction strategies.
Our multi-disciplinary team can provide counselling, psychology, hypnotherapy, Mindfulness training, physiotherapy, exercise therapy, hydrotherapy, acupuncture and massage, all of which are evidence based therapies that assist with the management of chronic pain. And the great thing is that no referral is necessary to see one of our team. However, you will need a referral to see one of our pain and rehabilitation specialists, Dr Geoff Speldewinde or Dr Keith Chan.
So if you think that you may have a problem with codeine or you are worried about someone you know, you might like to come to one of our regular and inexpensive two hour ‘Functioning With Pain’ education and planning sessions, run by our pain counsellor and program coordinator Jude King, to help you make a plan for treating your chronic pain and put you back in control. Alternatively you can make an individual appointment with Jude, or one of our psychologists Michelle Linmore and Tom McHugh. Exercise is also extremely important in helping with pain and our physical therapists Andrew Powell, Carla Zijlstra, Nina Semenov and Tracy Rowe can help you to develop an exercise plan suitable for you.
We encourage you not to wait until 1st February 2018 for help with your pain management. For more information and to make a booking contact our friendly reception team on 02 62820 6240.
Jude King Clinic Program Coordinator, Pain & Infertility Counsellor and Hypnotherapist