My wife has been deeply anxious

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Hi

My wife has become almost cripplingly anxious after she accidentally gave a colleague what she thought was paracetamol she had in her bag but it was in actual fact my co-codemol and her friend reacted badly to the codeine. She took her colleague to hospital and she was monitored and sent home a couple of hours later.

This was 7 months ago and my wife hasn't been able to stop thinking about it and thinks that every time there's anything else wrong with her colleague it must be linked to that and its all her fault. My wife is now having CBT to help her move on from it but i was hoping someone could explain the biological process codeine has and is there any possibility it could cause long term harmful effects that lead to other issues?

I'd dearly like to be able to put my wifes mind at rest and get her back to her old self.

Thanks

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  • Edited

    Hello,

    I'm a retired medical professional from the U.S. and I'll respond here to your request in the hopes it can bring more light to the matter at hand.

    One of the most critical points that your wife needs to realize is that virtually all of the potentially serious side-effects associated with administration of codeine are those which arise with continued use over extended periods of time. Any relevance to a reaction as a consequence of a single administration of co-codamol is entirely separated from the range of side-effects more often observed in patients.

    Codeine itself is an alkaloid prepared from either opium or morphine through the process of methylation. As such, one of the main concerns with any opioid is respiratory suppression. If a person who is administered codeine demonstrates a hypersensitivity to the medication, difficulty breathing could occur within minutes of administration or alternatively arise as much as 72 hours post-administration. In extremely rare instances, hypersensitivity reactions can result in metabolic disturbances and even more rarely, has been considered by research to manifest autoimmune response by the body. Understand, however, that such instances are on the furthest extent of rarity and well outside the remotest possibility to the be case at all where your wife's friend is concerned.

    With respect to your wife's extraordinary response to the misfortune she believes that she has initiated, it is largely due to her unfamiliarity with clinical medicine in general that is compounded by extremely irrational beliefs that she has imposed some type of permanent damage to the health of her friend that could by some means represent permanence. You can share with your wife that I retired after more than 40 years in practice and in all that time never once read of a case report wherein an accidental or intentional single dose of co-codamol resulted in permanent injury or death. It's important to place the unintended and unexpected outcome in context with the actual facts at hand. I'm uncertain what dose was provided, but co-codamol is pharmaceutically a combination of paracetamol and codeine phosphate, with codeine representing but a fraction of the total compound. In the case of your wife's friend, it is far more likely that a hypersensitivity reaction resulted from exposure to the codeine absent any dose-related factor.

    Your wife needs to realize that her absence of direct clinical training and experience over time in such instances has, as previously mentioned, resulted in an irrational perspective that she is unable to extinguish from obsessive ruminations because she has no point of rational reference by which to offset her misconceptions of the facts. It's important for your wife to realize that she's been fortunate and given reprieve from the original decision to share medications with a person absent the clinical knowledge and experience so heavily associated with doing so. It is, however, critically important for your wife to now understand in a very graphic context just how reckless it can be to offer medications of any type whatsoever to a person for which that medication was not formally prescribed by a licensed physician. It is never, in any instance and regardless of the circumstances, proper to do so.

    In other words, she can relax in knowing that no long-term harm or permanent damage is going to arise as a consequence of her actions. Her worst fears can be put to rest in that regard. While it is unfortunately a lesson hard-learned, to say the least, she needs to put the matter to rest in knowing that the long-term health of her friend has not been compromised to any extent. She also needs to be reminded that any health consequences that her friend may encounter throughout her life did not arise from and has absolutely no correlation to the single administration of the co-codamol. To otherwise remain entrenched in such an irrational belief or fear is entirely outside the parameters of the actual reality being passed along to her by a retired physician with more than 40 years of clinical experience.

    Best regards

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