One of the many faces of codeine addiction

Amanda Lyons

6/11/2017 10:51:00 AM

Jessica Khachan lives in Sydney with her husband and two kids, who are 14 and 12, in what she describes as ‘a normal suburban household’. She is also one of the increasing number of Australians with a history of codeine addiction.

Jessica Khachan shares her experiences with codeine addiction.
Jessica Khachan shares her experiences with codeine addiction.

As part of the effort to curb the misuse of over-the-counter medications in Australia, codeine will be up-scheduled to be prescription-only from 1 February 2018.
newsGP sat down with Jessica to discuss her experiences.
How did your experience with codeine start?
I got three wisdom teeth pulled out and when the dentist asked me if I was allergic to anything; I told him, I’m ‘allergic’ to alcohol. I was very naïve and thought he would understand what that meant. I didn’t actually tell him that I was an alcoholic in recovery.
He prescribed me hydrocodone and I thought that because it was prescribed from a doctor it would be okay. I took it as prescribed, I think, for two weeks. When it ran out, I just went down to the chemist and bought a box of Nurofen Plus. It was about a two-year period that I was taking them [Nurofen Plus] and over that period it escalated until the very end, when I was taking up to four packets of Nurofen Plus a day if I could get my hands on them.
Did it feel like an addiction?
No, I was unaware I was actually addicted. When I didn’t take them I felt really down and couldn’t do anything. I felt like I needed them to cope, to be able to manage the days. When I took them it made me feel normal.
Somewhere in my head I thought, ‘I know I’m taking too many and I need to stop this’. I had been to rehab before and I thought I’d try weaning myself off. Honestly, I couldn’t, it was impossible. I know today there was no way I could have come off them on my own.
It did take its toll. I started to get really sick, I lost a lot of weight and I stopped getting my menstrual cycle for almost a year.
[The codeine was] no longer giving me the energy that I wanted. I ended up with anaemia, my skin went all green, my hair was falling out. My family started to notice that I was more tired than usual, I was falling asleep. I couldn’t tell them [about the codeine] because I felt so ashamed of myself.
I got to a point where I got so depressed I just wanted to die. That’s how low I got.
How did you end up getting help?
I said, all right, I’ll get a blood test, to get the family off my back. The minute the doctor saw me – he was a really good doctor, too, our family GP at the time; I went back and gave him a hug and said thank you, he actually saved my life – he said, ‘You’re anaemic. Get a blood test now’.
The doctor called my husband at a quarter to midnight and said, ‘Get your wife to the hospital now’. I was in the emergency ward and they gave me a bag of blood, a bag of iron and sent me home the next day, but asked me to come back in six weeks for an endoscopy.
At home, I couldn’t walk. I was just in so much pain. I remember asking my husband, ‘I need some Nurofen’. I had so much stomach pain, I couldn’t get up and walk. At this stage I weighed about 30 kg.
My sister took me back to our family GP and the minute he saw me he said, ‘Why aren’t you in the hospital?’ He ended up putting me straight into hospital and made an appointment for me to see a gastroenterologist.
I had to detox for a couple of days. They gave me five blood transfusions, more iron, I was on drips as well. When I woke up from my endoscopy, the specialist told me, ‘You’ve got a stomach ulcer and that’s one of the biggest I’ve ever seen’. He said, ‘No more anti-inflammatories for you’, and I haven’t had any since.
It was something in the way he said it, and it was the experience I had. I never want to go back to that, it was just a horrible place to be, mentally, physically, for everyone around me.
Addiction is a health issue. What helps me is looking at it as a disease, like diabetes, understanding and accepting it that way. It’s a health condition – you just can’t break it on your own, you need help and support and people that understand.
What effects do you think codeine up-scheduling will have?
I think it’s a good idea. When I was buying them myself there was no help offered. No-one ever stopped and said anything about addiction.
The only comments I ever had when I bought them were, ‘Have you ever had these before?’ and ‘Don’t forget to take food with them’. And these were some of the pharmacists that I saw repeatedly, weekly or every two weeks. You’d think that someone would have caught on, but the drugs were easy to get.
I just hope that, come February, there are options available to people that are looking for help and support. That’s what I found was really difficult, breaking the cycle.
What would you like GPs to know?
I think it would be great to be able to have conversations with doctors where you’re not judged. People from all walks of life are dealing with these issues, and we’re not park-bench drunks or addicts that live under bridges and things like that. We’re just ordinary house mums and husbands. Some of us are working people and we pay taxes and all that stuff.
You just need someone to let you know you’re not alone, that it’s not so shocking, it’s common and there is help out there. Addiction is nothing to be ashamed about, because it is an illness, it isn’t a choice, and we don’t want to be like that. We need help.
What is it like to now be on the other side of it?
I look at it as, I almost died, and what a waste it would be to just get on with life and not mention it to anybody. How many people would miss out on an opportunity to find recovery or a drug-free life? That’s why I don’t mind sharing my experience because it might help somebody else. And if it’s reaching doctors, I hope they would have a different view of how to treat addiction.
This interview has been edited and truncated for clarity.

codeine codeine-addiction pain painkillers pain-management

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Bambi Markus   7/11/2017 10:10:10 AM

An incredible lesson to us all. Thanks for sharing.

Daniel Byrne   7/11/2017 10:57:27 AM

Great story. Exactly what we are trying to get across. This is a public health issue for GPs and a financial issue for pharmacists. Safety first - do no harm.

Dr Jim Marwood   8/11/2017 9:48:55 AM

This is a very good argument for prescription-only NSAIDS, since that's what was killing the patient.

Arshad Merchant   8/11/2017 5:36:24 PM

Why is every problem dumped on GPs, why cannot pharmacists take some responsibility so as the patient themselves. What's next prescription for alcohol and cigarettes. At one end, there are medical marijuana clinic pilot going on and we now curbing codeine when you can now request script online. I will suggest linking every over the counter medicine regardless to central database. Yes it is a huge work but a realistic solution.

phillip   8/11/2017 9:53:54 PM

Perhaps alcohol should be prescription only too?

Jenny   16/01/2018 8:28:51 AM

This article has nothing to do with codeine addiction and is all about the adverse effects of nsaids. Not sure what you are trying to represent .

Dr.Alsharik   9/06/2018 11:35:53 AM

This article focus is on ibuprofen side effects not codeine

Mihiri   16/01/2019 9:30:29 PM

Just a reply to those complaining about this interview NOT being about codeine addiction:

It IS about codeine addiction.

The addiction to the combination drug (which contained an NSAID + Codeine) prompted this lady to take supraclinical doses of the drug just so that she could get a better high (the high is only from the codeine component). Unfortunately, along with the codeine comes the NSAID (codeine is rarely a splitary preparation. It is usually combined with an NSAID or paracetamol/acetaminophen), and the morbidity of this addiction is due to overdose of the component drug, ie the NSAID or the paracetamol...

So yeah, this article talks about the side effects of NSAIDS which occured BECAUSE of the codeine addiction.

(Note: NSAIDS and Paracetamol are NOT habit forming. But codeine is habit forming.)

Ben Muddiman   21/01/2019 1:10:27 AM

do any of you know what Nurofen Plus is? Its ibuprofen with CODEINE. Granted its only 12.5 mg of codeine but its still relevant. Jesus

Albert   30/01/2019 12:54:02 PM

Agree that this is about NSAIDS side effects and not codeine

Mary Arnold   16/02/2019 11:52:43 AM

I feel that others are right relating to tha story being predominantly about Ibuprofen . All the treatment that we read about was centred on the secondary drug, Ibuprofen andNOT on the treatment or the symptoms relating to a detox. Perhaps it would help people to realise the dangers of CODEINE if detox instructions were added to the INSTRUCTIONS FOR USE, it would certainly have alerted me.

Annatjie   23/05/2019 5:26:33 PM

This IS about codiene. If you have never been a user of NUROFEN will not understand. Myself, on the other hand....knows exactly what this women is all about, as I was in the same space with the exact same product. Only difference is that I used less per day and quit after 5 years of daily intake. I knew it was effecting my health and I had to stop. But this women's story could as well be mine. The feelings she described when using and not using is similar to mine. Thank you for sharing your story. I was looking up high blood pressure today and came upon this testimony.....(as this is my take on it....a testimony). Thank you. God bless

Annatjie   23/05/2019 5:29:34 PM

This IS about codiene. If you have never been a user of NUROFEN will not understand. Myself, on the other hand....knows exactly what this women is all about, as I was in the same space with the exact same product. Only difference is that I used less per day and quit after 5 years of daily intake. I knew it was effecting my health and I had to stop. But this women's story could as well be mine. The feelings she described when using and not using is similar to mine. Thank you for sharing your story. I was looking up high blood pressure today and came upon this testimony.....(as this is my take on it....a testimony). Thank you.

Against the Aussie nanny state   25/05/2019 1:09:16 AM

The addiction was codeine, the adverse effects were from NSAID overuse (ibuprofen). Similar with Panadeine, liver failure is what kills you, which is caused by the paracetamol, not codeine.

James Gibson   30/06/2019 10:37:44 PM

If codeine was sold on its own, this lady would still have been addicted, but she would not have suffered any of the terrible health consequences. Lacing toxic and deadly medications like NSAIDs with addictive medications like codeine is one of the stupidest ideas ever devised. The ultimate outcome will be cases like this.

Lynda   13/07/2019 10:39:36 AM

I have fibromyalgia and have been taking Panadeine Forte for around 6 years... if I don't take it my mood is shocking my anxiety is worse and I have no drive to do anything. The codeine seems to make me motivated and after reading this article I know I'm addicted.

Izzy   2/09/2019 11:44:11 PM

I, too, have had fibromyalgia for 26 years and over time have increased my dose of Codalgin Forte (Panadeine Forte) from 1 tablet per day to 6 tablets per day (180mg codeine per day). I increased it mainly because I developed Burning Mouth Syndrome 8 years ago and it is the only thing that eases it a bit. I have been to an oral pathologist and my GP has allowed me to dry various dugs that have sometimes worked for people. None work for me.
I am concerned about my liver, given the amount of paracetamol I am taking. I don't know why doctors can't just prescribe low doses of codeine by itself.
I am going to start tapering but I don't know how I will cope. The codeine definitely gives my mood a lift.
How quickly can you reduce from this level?

JS   5/09/2019 9:56:38 PM

I’ve just reduced from 360mg per day for over 2 years for nerve pain. I’m 5 days free now and I started at the beginning of June. It takes time and patience and can be a little uncomfortable at times but it can be done. Doctors can prescribe pure codeine as mine did to help me taper. I was also already on 30mg caps of pure codeine so it is available although maybe not where you are. Your mood etc will eventually recover once you get off it but you will need to find other ways to manage the original pain and that’s the tricky part. You need to speak to your doc and work with them on this. It can be done though. Best of luck.

T t   28/09/2019 10:01:08 AM

This is definitely relevant.
I started taking nurofen plus for period pain 8 years ago.
I have taken codeine ever since. I never went to extreme. 2 packets a week. I'd never take more than the recommended dose. However when I don't have it. I get restless legs and severe anxiety and head pain.. its terrible.
I wish i could stop. I now have 3 panadine forte a day and I am weening off. But whenever I have NONE. I feel terrible.
I knew they were addictive. I thought I was stronger than it.
Now i am here :/

Ryan   22/12/2019 1:47:02 AM

So she got off codiene because the ibuprofen nearly killed her? Reminds of how they used to out methanol and other denaturing agents in ethanol during the prohibition in the USA.

Bec   4/01/2020 3:18:10 PM

Gosh this hits me so hard ! For years my doctor has prescribed me codeine for y fibromyalgia . I started off with just one a day but gradually it increased to around 6 a day. I stopped codeine for around 6 months , then I would start again . Kept doing this for years. I’ve developed diverticulosis , ibs and al kinds of tummy issues. All because of codeine ! The first 3 days are horrendous so if you do stop taking it , get some powerade or gastrolyte or anything that replaces what you lose with the chronic diarrhoea and get wheat bags and for the pain as your legs will hurt so much. But believe me it’s so worth it when you know you’ll be a lot healthier . Give yourself at least 10 days at home . Make sure you have support too. Many complications can arise with codeine withdrawal so if you feel too sick then get to a hospital. Also there’s nothing wrong with tapering too. Each week lower your dose by half and the withdrawal won’t be as bad. It just takes longer.

Coastal girl   5/02/2020 1:02:58 PM

I was on panadeine forte for endometriosis and all types of women's business that brought me severe pain. After a full hysterectomy and still the pain persisted. I was on 8 a day. Sometimes sleeping tablets. I stopped going out, surfing, seeing friends. I moved everything into my bedroom. I sold off all my possessions that were worth something over the five years. I hid my shame from my family and friends. I constantly sweated, had the runs and felt horrendous. If I missed a dose or cut down when I did work I would be sweating and running to the toilet. I am addicted. It started with panadeine 15. I am fifty and on Australia Day when I realised everyone was out celebrating I made a decision to stop. I stopped cold turkey. I had the worst five days of my life. I told my doctor on day 3 I had not slept in two days. He prescribed valium for restless legs. Buying imodium is not cheap. Cream for my bottom from the runs. And now I am on day 10 and feel horrible but free. Pain is still here.

Geoffrey b   1/03/2020 10:58:08 AM

I have been penadeine forte for 22 years so far I have no problems with it still takes the pain away and my kidneys and liver are fine

Pamela Parker   16/04/2020 5:35:51 PM

I have seen people who, when they were out on the street and there were no drugs available, go through extreme machinations of withdrawal.

Darla djurdjevic   11/05/2020 10:08:44 PM

I have been taking panadein for many years have got down to 6 a day but can't get off them I am starting to get worried has anybody got any suggestions thank you

Waggy UK   27/06/2020 1:18:15 PM

A frank & honest account of how easy it is to get addicted to Codeine. Thanks for disclosing x
So many people overusing NSAID’s (which nearly cost this lady her life) just so they can get codeine.
Well done for trying to do something to help prevent others from making the same mistake. In essence, allowing codeine as an OTC medication normalises something that is incredibly habit forming & extremely dangerous. Well done

Kim   1/10/2020 12:03:56 PM

I am 1month off nurofen plus and I am struggling. I have taken them for 15years. The first 2 days was horrible, anxious, nauseous, cranky, couldn't sleep, no energy. I understand completely and it's a horrible place to be. 1month now and I'm still craving though not physically, just have low energy as the codiene boosted me through the day.

Phoenix   1/10/2020 4:10:16 PM

This is not about Codeine at all. Its about ibuprofen. Duh it eats your stomach away whether or not it had codeine. Panadeine forte is safer, she could have gone to that alternative. It still has codeine and still gives you the high.
I have been on Panadeine forte for 5 years. I never take more than 8 each day. I have a curved spine from a fall and this drug lets me work and get on with my life.
Just because some people are using it for fun it doesnt mean you should put a bad name to it. Codeine is only lethal in high doses over 300 mgs not 30mgs.
Never had any issues with my gut, liver, heart breathing or anything. Its safe for pregnant women. Panadeine forte is the cure drug. Takes away pain and lets me sleep well and eat well.

Drinking 10 bottles of beer every weekend harms your liver more than taking 8 tablets of panadeine forte per day. This country should be banning alcohol and not pain killers.

Naomi   21/10/2020 10:05:52 AM

I have been addicted to Nurofen Plus for 15 years. Mine started after a dentist recommended I take it to help my pain after having root canal treatment. After feeling that europhric feeling I could stop. I have been so unwell from taking this. I had a perforated Ulcer, I have been in ICU 4 times ventilated as my body started to shut down... I urge everyone to stop. The hardest thing for me at The moment is deep depression and fatigue. But as time goes on I know the chemicals in my brain will correct over time and so will my fatigue. It's the hardest thing I've ever gone through but I need to save my life..

Dr Abdul Ahad Khan   30/03/2021 10:14:15 AM

I am genuinely concerned that Nurofen is being pushed instead of Paracetamol in Children with Fever / Pain.

6 months codeine free   3/10/2021 6:17:06 AM

The author told my story but only half of it. I didn't know I had ulcers in my stomach (due daily high levels of ibuprofen). Ibuprofen doesn't make you high but in the UK, you can't buy pure codeine OTC. I got addicted to NP after my 1wk codiene prescription ran out, for toothache. But for me, too late, I was already addicted.
32-48 Nurofen Plus daily for over a year. It helped my workload, volunteering and nobody knew! But I was getting ill, thin, anaemic and vomited a lot. And I couldn't stop.
One night, the ulcer started bleeding. I'd already got to hospital before it burst. A perforated gastric ulcer and there truly are no words in the English language to describe the pain.
Emergency op saved my life, long recovery.
It's a hidden addiction here. Nurofen Plus is evil, why don't they sell 12.8g codeine without the Ibuprofen? Same pack size?
To other addicts: buprenorphine is the only drug that's kept me off NP/codeine and has saved my life. If you're UK, ask your GP. 🙏

6 months codeine free   3/10/2021 6:31:30 AM

Naomi, I hope you're better now but if not, please get some specialist help because, like me, it's killing you.
Please ask your doctor/drug counsellor about opiate replacement therapy. Buprenorphine stops the awful withdrawals/cravings but doesn't get me high. I've got my life back, eat/sleep better and I feel happy. I'm prescribed 24mg and will reduce just 2mg at a time.
NP was making my depression worse as I knew my insides were giving up. I carried on using after my burst stomach ulcer which is insane addiction.

For me, buprenorphine was the only way in the end and I'm so grateful.

Methadone on the other hand, is very addictive but still healthier than NP for us hardcore addicts.

Sending love, best wishes and recovery.

Tiffy   27/10/2023 3:08:49 AM

This is a really good article and I have found many of the comments so useful. 6 Months Codeine Free your comments were particularly helpful! I’m currently taking codeine for both fibromyalgia and endometriosis and to be honest I’ve been on and off of it for the past 20 years due to those conditions. I’m currently waiting for a hysterectomy and no other painkillers work. I used to be on Tramadol which my GP says is 10 times more addictive than Morphine and took myself off of them, ironically because I didn’t want to become addicted to them. Codeine has been the next effective thing. I’ve come off them many times, endured the pain, restless legs and diarrhoea that goes along with withdrawal and it’s awful! But it can be done!! Unfortunately I have to take them to cope with the pain of endometriosis until my op although I know I am currently addicted to them. I think doctors should introduce a gradual withdrawal programme with alternatives as standard as addiction is a given fact