OVERCOMING ADDICTION TO CODEINE

A 19 year old boy died of methodone overdose our local paper told us yesterday. Another junkie bites the dust? No, the story goes on to say that he became addicted to ordinary prescription painkillers. He had a dislocated shoulder and had been given the tablets for the pain. In a short while he was addicted. The methodone, of course, was supposed to break the addiction.

Meantime, my own dear husband developed arthritis in his hip. X rays showed that he had no cartilage whatsovever, bone on bone, with excruciating pain. He was given co-codamol for the pain on prescription, which continued after his hip replacement operation. Came the day when there was no more pain, and he thought he didn't need the painkillers any more. But he too was addicted.

Stopping the tablets made him feel very ill, with aches in arms and legs, restlessness, depressive feeling to the point of suicidal thoughts, heart palpitations, breathlessness, feeling cold, and a general feeling of being unwell. It took us a day to realise it was withdrawal from the tablets, and reading the leaflet in with the pack, it told us exactly that! Back on the tablets, he returned to normal within an hour!

How common is prescription medication addiction? Well, there doesn't seem to be any information that we could access. But there are sites on line which talk about codeine addiction. A friend who works in a local pharmacy, said that there were a number of people who came in regularly for codeine/paracetamol tablets whom they had on a 'watch' list.

Why is codeine addictive? Simply put, it is an opiate in the same family as tramadol, morphine, and heroin. And we all know how addictive heroin is.

So, if you found yourself addicted, what can you do about it?

The sites we looked at all recommended going 'cold turkey'. That is, to just stop the tablets. It would take five days to be free of the tablets, but each day of those five days would increase the symptoms of withdrawal. The pain would increase. (We assumed they meant headache, although my husband did not suffer that; perhaps they meant other, nerve or muscle pain, particularly in the arms and legs.) It did not sound like an option for my husband who has suffered a heart attack two years ago and we did not feel we could risk the palpitations and breathlessness.

So we went to our doctor, who flatly told us that he didn't think the symptoms my husband experienced could be co-codamol withdrawal! He thought the symptoms could be down to thyroid dysfunction, so he ordered a blood test (ten days to get a blood test, and another five to get the results.) Then come back and see him.

Back to our friendly website, where one person in America said that her doctor had told her to halve the medication for a week, then again for another week and so on. She decided to go cold turkey, so we have no idea how she got on. But we decided to try that method on our own.

As the tablets were 30 mg codeine and 500 mg of paracetamol each, and the dose had been two tablets four times a day, making 60 mg of codeine per dose, or 240 mg per day, we could halve the dose by cutting out one tablet. So that's what we did. Initially, he had a few small effects, especially as the time for the next dose came near, but in a short time the body adjusted, and five days later we felt ready for the next drop.

However, where could we get 15 mg of codeine? Well in Britain, you cannot buy codeine on its own over the counter. You can buy 20mg codeine with ibuprofen over the counter. But heart attack patients cannot take ibuprofen. But we could buy 8mg codeine/500mg paracetamol tablets. And only 32 of them at a time. Why? Because the pack tells you in plain language that they are addictive!

Anyway, so now it was 2 of those four times a day, and that lasted for four days until the next drop, which was down to just one 8 mg tablet per dose. The first day he had four doses. The second day he had three doses, but the arm and leg aches returned just before each dose. The day after (getting impatient here) he dropped it again by cutting the tablet in half. He had one half (4 mg) twice that day, but just before bed the aches got worse, so he succumbed to an 8 mg. The next day he had no tablets at all until just before bed, when the arms and legs ache came on again, when he had a half tablet (4 mg.) But he did have a very bad night. The next morning he didn't seem to need any, but again just before bed-time he had to have another 4 mg.

The day after he decided he wasn't going to have the one before bedtime at all. So a completely codeine free day. The aches came on again, but he took two ordinary paracetamol. He had a bad night's sleep, but survived it.

Yesterday he had no tablets, and no aches only a 'slight feeling' in his arms, and a good night.

The whole process took us 17 days to be completely free.

We found also that a good all-round B vitamin tablet helped with the depressive feelings.

Was it easy? Well, no. Each time we halved the dose, the body reacted, especially at the time just before the next dose was due. The reaction, though was a lot less than the day when he thought he would go cold turkey! It was do-able.

As for me, I have needed a lot of patience to support him. I had to keep encouraging him. He could do it. I had to remain positive. And when he was bad-tempered (unusual for my normally placid husband) I had to try not to be bad tempered back. Well, we've been married over 42 years now, so we have learned to support each other in love.

Another thing that helped was keeping a chart of the time and what tablets taken. When we found it hard going we could look back and see the progress he had made.

Now he is free. Never again will those wretched things darken our doors. It's been a fight, but we got there.

I have published this post because others may benefit from our experience.


Evelyn Tidman is the author of factual historical novels GENTLEMAN OF FORTUNE The Adventures of Bartholomew Roberts, Pirate; ONE SMALL CANDLE The Story of William Bradford and the Pilgrim Fathers; FOR THE KING, Roger L'Estrange and the Siege of King's Lynn.

evelyntidmanauthor.com

THE GOOD OLD DAYS?

Today we live in a world of indoor plumbing, central heating, electricity, to say nothing of the technology which seems to have overtaken us. But what was it like for poorer people in Britain years ago? Even fifty or sixty years ago, people seemed to be living in the 'dark ages'.

Modernisation came slowly to rural areas. My grandmother lived in a cottage in the Essex countryside in the fifties with no electricity. She had gas-lighting. She had to pull a chain on it to start the gas coming through, and put a match to the 'mantle' a small dome-shaped mesh (about an inch or so across and perhaps an inch and a half long) which over time would disintegrate and have to be replaced. You would have to get a new one (came in a box of six) from the 'ironmongers'. They were so delicate that when they had been used once, if you touched them you would put your finger through them. I always worried that Gran would gas herself, or us (in the days of coal gas, you understand) or that she would blow us all up! It used to make a loud 'poof' as it ignited! But it seemed to work. The gaslight had a peculiar smell which never seemed to dissipate. Makes you wonder how they didn't all asphyxiate from carbon monoxide poisoning.

Of course, there was the open fire. Everyone had an open fire. In London the accumulated smoke from domestic and industrial use of coal combined with certain weather conditions to produce a thick smog. I can remember my Dad having to follow a bus home one night, because you just could not see further than ten feet ahead! 

Because you had just one coal fire in the house, you lived in one room and spent the evening huddled around a minute black-and-white television with a screen no bigger than a tablet today. The bedrooms were unheated. Net curtains stuck to the windows with frost in the mornings, and you could see your breath. Everything was done in the one living room - you washed in the adjoining kitchen, and you dressed in front of the fire if you did not want to catch pneumonia. The 'front room' which was supposed to be 'posh' was not only unheated, but also abandoned, and became the dumping ground for everything no-one knew what to do with. 

Later, we graduated to a sparkly new gas fire. But when that new-fangled thing called central heating came in, many people avoided it, not just because of the expense (all that money to install a lot of radiators!) but also because they thought it was unhealthy! This at a time when everyone smoked, and we kids were almost kippered from the smoke of the fire! People also thought that sleeping in a heated bedroom made you weak. You needed to be toughened up! And everyone knew that running gas central heating was so expensive. Well no. The cost of running it was on a par with running a gas fire all day! I did not experience central heating until long after I was married when my husband and I moved to a new house in Norfolk, which was in 1979. And we were the exception then.

Gran in the cottage had a toilet at the bottom of the garden in a shed full of bits of wood, spiders and their huge webs, to say nothing of the mice and rats. The toilet consisted of an oil drum (a large round tin can about 3ft high, rusting and really unlovely) with a toilet seat perched precariously on it! I wouldn't go down there if I could help it! What did they do with the contents of that oil drum? Well, some people dug a hole in the garden and buried it! Ugh! In Norfolk they had the 'honey cart' which came round at night and collected it. I wouldn't like to say what happened to it then. 

In our small Edwardian terraced house in London, we had the luxury of a fully flushing toilet (with the cistern suspended above your head and a long chain for the flush).  However, it was 'outside'. Thankfully we had a 'lean-to' or glass conservatory-type building to keep the elements off, which was a luxury our neighbours did not have, but it was still perishingly cold in winter. Most people thought an indoor toilet was 'unhealthy'. More unhealthy than constipation because you couldn't sit there long enough because it was so cold? People had a chamber pot (affectionately called a 'guzunder' because it goes under the bed - get it?) for night time.We had running hot and cold water, but no proper bathroom until Dad built an extension on the house. We kids were washed in the kitchen sink. And the toilet stayed outside.

Grandmother didn't fare so well. She had a tin bath. I don't know if, at her age, she ever used it, but tin baths were usually placed in front of the fire in the living room, or in front of the range in the kitchen if there was room. Water was heated on the range and tipped into the bath and the family would start with the youngest child and work up to Father. He probably came out dirtier and smellier than he went in! Hair was washed in the kitchen sink, teeth were cleaned in the kitchen sink. All washing of bodies and clothes was done in the kitchen sink. Clothes were wrung out using a mangle, which fascinated us kids!

My husband and I moved out of London to Norfolk in 1979. A friend of mine brought up in King's Lynn, Norfolk, also in the fifties, did not even have running water. Instead they had a pump at the end of the street. Mind you, we still have a saying in Norfolk that the county is at least ten years behind the rest of the country! I wonder if that is still true? Technology is creeping in even here.

Sometime in the sixties, my grandmother moved out and the cottages (which were probably extremely picturesque and would be worth a fortune today) were demolished, and she went to live with my aunt and uncle, being deemed to old to care for herself. She died aged 79 in 1962.

Ah! Those were the days! The good old days? Give me modern conveniences every time.

Evelyn Tidman is the author of GENTLEMAN OF FORTUNE The Adventures of Bartholomew Roberts, Pirate and ONE SMALL CANDLE The Story of William Bradford and the Pilgrim Fathers available from Amazon in print and in Kindle: US   UK   Australia   Canada . For other countries please see Amazon.
See website: www.evelyntidmanauthor.com