Co-codamol addiction

Co-codamol is an opiate based drug and just like other opiates has the potential to lead to addiction.

Tolerance and dependence to co-codamol can occur within as little as 3 to 5 days of continuous use. This is why all co-codamol products, whether over the counter or prescribed, now carry a government health warning label.

Co-codamol can be used safely and effectively when taken exactly as prescribed or instructed.

Problems with co-codamol addiction generally occur when a person abuses the medication, although co-codamol dependence and addiction can form through a genuine but prolonged prescription.

Co-codamol is one of the many codeine based opiate drugs that can still be purchased in the UK without a prescription. Because of this there has been an increasing trend of codeine related abuse and deaths.

All opiates can be potentially lethal when abused, however because co-codamol can be purchased, there is still a misconception that recurrent use or abuse is safe. This is far from the truth

If you or a loved one have a problem with co-codamol it is important to seek professional help sooner rather than later.

Please call our team of addiction treatment experts here at Delamere who will be able to advise you of our inpatient co-codamol detox and treatment programmes.

What is Co-codamol?

Co-codamol is a combination of two popular painkillers – codeine and paracetamol.

Codeine is often mixed with other less powerful painkillers that are non addictive, such as paracetamol, ibuprofen or aspirin.

Combining codeine with other analgesics increases its pharmaceutical efficiency in relieving coughs and pain.

Co-codamol usually comes in pill, capsule or effervescent tablet form and is available in various dosages over the counter and on prescription.

Low dosage co-codamol of 8mg strength can be purchased over the counter at your local pharmacy and is available under different brand names.

Always consult with your pharmacist before buying medication containing codeine so that you can take the one most appropriate for you and your condition 4

Higher doses of co-codamol of 15mg and 30mg strengths are available on prescription only and are controlled drugs.

Co-codamol can be used to treat conditions that do not respond to other non opiate based painkillers and remedies.

Co-codamol is commonly used in the treatment of:

• Toothache
• Backache
• Earache
• Injury pain
• Post operative pain
• Infection related pain 4

Due to co-codamol containing an opiate it is not recommended for the use in children under 12 years old as it can cause breathing problems 1

Abusing co-codamol can cause addiction, overdose, coma and death.

Due to co-codamol containing paracetamol there are additional dangers associated with its abuse including paracetamol overdose, liver damage and liver disease.

Is Co-codamol addictive?

Co-codamol is extremely addictive. For this reason it should be the last resort in over the counter pain relief medication. Your doctor can also prescribe stronger types of pain relief that are non opiate based and are non addictive.

If you have ever had a problem with drugs or alcohol, you should avoid taking co-codamol in any form and consult your doctor first.

Some people may think that only prescription strength co-codamol is addictive. It is important to be clear here – Co-codamol in ANY strength has the potential to lead to opiate dependence and addiction

Taking co-codamol continuously for more than 3-5 days can lead to withdrawal symptoms on stopping. Although this would be considered a very mild withdrawal, you may experience symptoms such as diarrhea, restlessness, irritability and cravings for co-codamol.

The longer you take co-codamol for and the higher the dosage of dependence, the more severe co-codamol withdrawal symptoms will be

Types of Co-codamol that can lead to addiction

All types of co-codamol, whether purchased over the counter at low dosages, or prescribed at higher dosages, have the potential to create drug dependence and drug addiction, if abused or used for a prolonged period of time. If you purchase over the counter co-codamol and are still in pain after following the directions and dosage please consult your doctor rather than purchasing more.

Can I get high on Co-codamol? – The effects of Co-codamol

If you are new to taking co-codamol but take exactly as prescribed or instructed then co-codamols euphoric effects should be minimised.

Initially, when taking co-codamol, especially at prescription strengths you may feel drowsy and have feelings of euphoria that make you feel calm and content. However, it is very wise to bare in mind that these feelings of euphoria very quickly subside when taking co-codamol for longer than a few days

The effects of co-codamol include:

• Feeling sleepy
• Drowsiness
• Dizziness
• Unable to concentrate
• Analgesia
• Constipation
• Nausea
• Slowed breathing
• Impaired decision making
• Reduced alertness and awareness
• Feelings of euphoria 4

Over the counter co-codamol is not indicated for the use in children under the age of 16 4

Co-codamol affects everyone differently. You should not drive or operate heavy machinery until you know how co-codamol affects you personally.

Some people are allergic to the active ingredient in co-codamol (codeine). If you experience any swelling, hives, intense itching, trouble breathing or anaphylaxis, you should stop taking co-codamol and seek urgent medical care.

Feeling high from the effects of co-codamol are more likely to happen when you first take the drug or if you abuse it.

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What is co-codamol abuse? The risks & dangers

Co-codamol abuse is when you take co-codamol in any form other than genuinely prescribed or indicated.

Remembering that co-codamol contains an opiate, the main danger with abusing co-codamol is that it can cause respiratory depression, coma and ultimately death.

In 2019. A total of 2,160 drug poisoning deaths registered in England and Wales involved an opiate.

Thats almost half of all drug poisonings registered for that year and is not dissimilar to previous years 3

Co-codamol can be abused in many different ways.

Types of co-codamol abuse include:

• Taking co-codamol purely to get high
• Mixing co-codamol with alcohol, drugs, opiates or sedative medications for increased effects
• Taking prescription co-codamol that does not belong to you
• Taking co-codamol more frequently or at higher dosages than indicated or prescribed
• Diverting the course of administration of co-codamol (ie. crushing and snorting tablets, preparing into a liquid for injection)
• Sourcing co-codamol from multiple places (different doctors or chemists so as not to arouse suspicion)
• Buying prescription strength co-codamol online without a prescription (darkweb)
• Continuing to take co-codamol once your original genuine pain has been resolved

The risks and dangers of co-codamol abuse include:

• Co-codamol overdose
• Death through respiratory depression or drug poisoning
• Becoming dependent on co-codamol
• Developing an addiction to co-codamol
• Risk taking whilst intoxicated by co-codamol (ie drug driving)
• Suffering paracetamol poisoning and damage to internal organs
• Coma

In 2018 there was an 8% increase in codeine related deaths in England and Wales according to the Office for National Statistics 2

Source: The prescriber/ONS Deaths relating to drug poisoning for England and Wales 2018

Signs and symptoms of co-codamol abuse & addiction

If you are worried a family member or loved one is abusing co-codamol, there are some signs and symptoms to look out for.

Physical signs of co-codamol abuse & addiction include:

• Frequent intoxication
• Slurred or delayed speech
• Pinpoint pupils
• Excessively sleepy
• Loss of appetite
• Clumsy and unsteady on feet
• Slumped and overly relaxed
• Slowed or shallow breathing
• Suffering withdrawal symptoms

Behavioural signs of co-codamol abuse and addiction include:

• Depression
• Times of acute anxiety
• Preoccupied with getting and taking co-codamol
• Continually taking pills
• Hiding medications
• Loss of interest in things they used to enjoy
• Becoming unproductive and unreliable
• Defensive and angry when challenged
• Withdrawal from family and friends
• Evidence of many pill packets or bottles
• Evidence of multiple prescriptions or buying from the internet
• Continuing to take co-codamol even though they have no valid reason or have suffered negative consequences
• Manipulating doctors and family members in order to get co-codamol
• Taking risks with their co-codamol use 5

Abuse of co-codamol can lead to addiction. Co-codamol abuse and addiction can cause death if not correctly and promptly treated.

Co-codamol detox

A co-codamol detox is required when a person develops a physical dependence or addiction to the drug.

Detoxing from co-codamol will produce opiate like withdrawal symptoms.

Depending on the dosage and duration of the co-codamol dependence, it is not always safe to wean yourself off the drug or stop it abruptly.

Long term co-codamol dependence or dependence to prescription strength co-codamol often requires a medical detox.

A medical detox for co-codamol will reduce the severity of withdrawal symptoms, reduce the chances of developing life threatening complications and reduce the chances of developing post acute withdrawal syndrome (PAWS) 6

A medical detox for co-codamol can be accessed at a CQC registered residential detox facility, such as the purpose built detox centre we have here at Delamere.

If you cannot afford private inpatient treatment for a co-codamol detox, your local drug and alcohol team will be able to assist you with a community detox plan.

Treatment for co-codamol addiction

Successful treatment for co-codamol addiction should consist of three clear stages. Each stage adapted to the individual persons treatment requirements and ideally each stage to follow on immediately after:

Stage 1 – Detoxification – Stopping all co-codamol use with the emphasis on continued abstinence from all mind altering addictive drugs

Stage 2 – Rehabilitation & growth – Once the co-codamol has been safety stopped, the brain then requires intensive rehabilitation. Co-codamol rehabilitation should consist of evidence based treatment methods that are tailored to the individual. A bespoke rehabilitation programme will enable continued abstinence, cessation of addictive and unhealthy behaviours, instil new healthy coping strategies to cope with everyday life and emotions, provide a sense of purpose, imprint relapse prevention techniques and heal repressed emotions. Any dual diagnosis illness should also receive comprehensive professional treatment. Rehabilitation should provide physical, psychological, social, emotional, occupational and behavioral healing

Stage 3 – Continuation of recovery – The addicted brain can never be cured but it can heal and be effectively treated to manage addictive behaviours and prevent relapse. This is a process that should continue to help the person to grow beyond their addiction and recreate their life without alcohol and drugs. Family and friends are also encouraged to seek healing as they too will be gravely affected by their loved ones addiction. It is vital that the person who was addicted to co-codamol continues to actively engage in their recovery with the support of professionals and/or mutual aid groups

Recovery from co-codamol addiction

At Delamere we use evidence based treatment methods combined with thoroughly researched and proven holistic treatments to bring about a complete transformation in a person addicted to co-codamol.

Here at Delamere’s purpose built addiction treatment and behavioural wellness facility, co-codamol detoxes are delivered by qualified nursing staff who work around the clock to ensure our guests safety and comfort at all times.

Immediately following on from a co-codamol detox we offer a uniquely bespoke rehabilitation and behavioural wellness programme. Each treatment and treatment plan is intricately tailored and flexible to adaptation. This ensures that we are providing the best treatment at all times in line with our guests treatment needs and the way they individually respond.

Aftercare at Delamere is far more than an outpatient programme, we incorporate the family and loved ones and are continually available for our guests. We assist their reintegration and continue to support their recovery, ensuing that all the hard work and change is not undone and remains a firm foundation for continued growth and positive change.

For more information on our residential co-codamol treatment programmes, please call and speak with one of our Delamere professional colleagues.

References:

1. Co-codamol and the NHS
2. Office for National Statistics link 1. link 2. Deaths related to drug poisoning in England and Wales: 2018 registrations. August 2019. Available from:
3. Deaths by selected substances
4. Co-codamol for adults NHS
5. Recognising the signs of addiction
6. PAWS – post acute withdrawal syndrome
7. Drugs, brains and behaviour – the science of addiction
8. Insight deficit may explain denial in drug addiction
9. Relapse prevention and the 5 rules of recovery