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 na├»ve 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

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.


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