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Codeine addiction is a serious problem

From Mr R. I. Dunkley, MRPharmS

Some pharmacists have to deal with the ravages of heroin addiction by supplying methadone or buprenorphine to their patients. But how many pharmacists have given thought to the patients that receive prescriptions for co-codamol or co-proxamol?

Some of these patients are just as addicted to their medicines as any of the heroin users and they will experience a withdrawal syndrome if the medicine is withheld — albeit not as severe as that from heroin but enough for it to be terribly uncomfortable.

The purchase of co-codamol over the counter is another source of worry to community pharmacists and the purchase of Solpadeine by addicts has become enough of a source of worry to the general public to spawn a website for people to share their experiences. Clearly, there is a problem with codeine.

However, I would ask fellow pharmacists to look at the composition of the tablet the public can buy over the counter. It consists of codeine 8mg and paracetamol 500mg.The addict wants the codeine but has to take a huge dose of paracetamol as well to get the hit. The danger is, of course, that the paracetamol will damage the liver, possibly resulting in death.

Could I suggest a way forward? There has recently been released a low-dose buprenorphine patch that gives a low level of the drug to the body and this, I think, would make people who have been on long-term codeine therapy able to give up the codeine and hence the paracetamol. The only other therapy for these people would be methadone.

I came across this medicine the other day with a visit from a drug company representative and I thought that it could make a really good treatment for codeine addicts.

Bob Dunkley
Leeds

Citation: The Pharmaceutical Journal URI: 10004276

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