Codeine addiction can happen to anyone, TGA changes will bring out an influx of addicts

Dose creep: It started with back pain, but eventually university student Emma felt like she was leading a "double life" trying to hide her codeine addiction from her family and friends. She would often take a packet of 30 in one go while out on a "walk", sometimes three times a day.
Dose creep: It started with back pain, but eventually university student Emma felt like she was leading a "double life" trying to hide her codeine addiction from her family and friends. She would often take a packet of 30 in one go while out on a "walk", sometimes three times a day.

EMMA was studying a science degree at the University of Newcastle when she began to suffer from severe back pain.

She found some relief for it when she took Nurofen Plus – a combination of ibuprofen and codeine – and at first, she stuck to the recommended dose.

“But I started to take an extra one or two because, quite simply, it made me feel happy,” Emma, not her real name, said.

“I felt like I was a nicer person, I could cope with the stress of study better, I felt warm and fuzzy when I took more than I should. It was fun, like a little getaway or pick me up in the middle of the day. Like a treat, almost. I really liked the way it made me feel.”

Within a year, her friends would roll their eyes or make a joke when she popped two tablets before a lecture.

But as her body adapted to the dose, she needed more for the same effect.

She was taking Nurofen Plus, Panafen Plus, or the Chemist's Own brand of ibuprofen and codeine – anything she could that had codeine in it.

Soon, her family members voiced their concerns.

She tried to stop, several times, but each time – within days –  she would start vomiting, and endure bouts of severe diarrhoea.

She could not stay still.

She was agitated, “ache-y.”

“I couldn't get comfortable unless I was in the shower or a bath,” she said.

One GP gave her a prescription for Clonidine to ease the symptoms of withdrawal. But a month later, she was back to taking at least the same dose as before, but often more.

“At the peak of my addiction, I was taking up to 90 tablets a day on a bad day, but usually 60.

“There is 30 tablets in a packet and I would take a whole packet in one go, sometimes more because my tolerance got up so high. I would often do this twice and even three times a day. It was an extremely lonely and isolating time.”

Somehow, she was still doing “amazingly well” at university, getting “fantastic” marks.

“I think because I could still function quite normally – I wasn't passed out in a ditch or really out of it or anything like that. I looked and acted quite normally, I just had this huge secret.”

Emma’s main source of stress was always making sure she had enough tablets, and worrying that a pharmacist would question why she was buying so many.

“I had to travel to different chemists so they didn't become suspicious,” she said.

“When this first started in 2007, you could still buy a huge packet of Panafen Plus, I think there were 72 tablets in a packet, so it was very easy to come by. After the rule change in 2009, you couldn't just get them off the shelf, you had to go to the prescription counter and speak to a pharmacist about what kind of pain you were having.

“Every time I went out somewhere I would be looking for a pharmacy.

“It was like I was leading a double life because I was also trying desperately to hide this from my family and my partner. I would sneak around, saying I was going for a walk and then I'd buy tablets and take them all before going back home.”

Emma’s addiction eventually ruined her previous relationship, and had an impact on her performance in a former job.

She found there was a stigma associated with codeine addiction, even in the medical community, having experienced judgment from several GPs before getting Suboxone treatment as a codeine replacement through Dr David Outridge.

“I have been ‘clean’ since January 1, 2015. Three years,” she said.

“Drug addicts aren't all homeless and unemployed ‘bums’. They are educated people with normal lives, supportive families, good jobs – human beings who have made a mistake and need help, not judgement from the very people they turn to in their hour of need.”

Emma said the new legislation coming into effect in February, when codeine would become a prescription-only medicine, was unfair on the people who used it responsibly.

“But if they were available only on prescription seven years ago, I don't think I would ever have become addicted to them,” she said.

“I worry that Dr Outridge will be inundated with new referrals, because GPs won't want to prescribe these drugs, and they don't know how to properly manage patients who present with an addiction like mine.

“If these changes can stop even one person from going down the path that I did, then it is probably for the best.”