Real time recording of codeine in Australia
Posted , 31 users are following.
Hi,
I'm a long time codeine addict, and due to real time recording of codeine have been refused sale of codeine. I understand the reason that the Pharmacy Guild have put it in place, but is that where it ends? Just refuse selling it to people? I feel like they have not thought things through in bringing in these new regulations. They obviously know there are addicts, but have they thought past the notion of just cutting them off? Are there any safeguards in place for those of us who are heavily addicted and have been so for many years now. I read stories of people who then approach their GP, and are told the only option is go cold turkey. I'm really struggling and would like to hear how others are coping with these new changes.
1 like, 268 replies
ellenbe
Posted
So, a catch up from me. I've fallen completely off the wagon and it's reversed over me...a number of times. The unfortunate find of a chemist that doesn't record was my total downfall. I've had codeine every night for the last 5 days.
What can I say, I feel totally weak and beaten. I can't believe I've done this. I'm really disappointed in myself.
So, I'm standing up, brushing myself off, and will try YET again. I will check in daily regardless of how I'm traveling.
Take care everyone, I hope you are doing better than me!
ellenbe
Posted
Still taking codeine. I'm not sure what I need to do to get through this. Hope everyone is hanging in there.
WilRo ellenbe
Posted
Hi ellenbe,
I ha e t even though about it for the last week now. The suboxone is working fantastically for me. I'm really amazed. While some people experience a slight buzz or euphoric feeling from it I don't have any of that. Just zero desire to take anything else. I've had no side effects from not taking codeine and the mental addiction and constant thoughts of wanting some are completely gone.
I know this medication isn't for everyone, I've essentially replaced one addicts with another but at least this one isn't doing any physical damage to me. I'm quite prepared to spend the next 2 years on suboxone before I even consider cutting down or attempting to stop. Those 2 years will allow my stomach, liver, kidneys and heart to heal from nurofen abuse.
I don't really want to start recommending it to people but if all else is failing maybe it could be something to consider. Maybe do some research on it and see what you think
Wilro
WilRo ellenbe
Posted
How are you going?
Please keep in contact with us here. Honestly, I think about you a lot and really want to help you in any way I can. We can do this. I believe in you and think you will overcome this. Please remember you are not alone in this struggle, there are many people who want to help and believe you will win the battle.
Wilro
WilRo
Posted
I've actually been feeling guilty for the last few days when reading everyone's posts. Sometimes I feel like I'm cheating by taking the suboxone and how it makes things much easier for me.
Don't get me wrong, I still have my problems and alcohol is a major one that I've slipped back into but as far as the codeine use goes, suboxone is just completely destroying my need and thoughts of taking any.
I know sometime in the future I'm going to go through a very rough time coming off suboxone but for me that's at the very least 2 years away and I hope in that time I'll be strong enough mentally and physically to deal with it.
WilRo
Posted
One more thing ellenbe,
When I found chemists that were not recording, I had a bit to drink to build up my courage and motivation and then went in and told them that I was addicted to codeine and to please put a note in their system to not supply me any more. I did this previously with MedsASSIST chemists but after I started taking too much (60 tablets per day) I also went into the 2 pharmacies that weren't recording and had them block me as well. I simply can't trust myself with the mental determination to not use if I can get it so I had to take extreme measures. Maybe that's an option you could consider. I know it's so difficult to willingly cut off your supply but in the long term you would be so much more healthy for it.
At the moment I need to take these sort of steps in relation to alcohol as my liver is probably begging me to stop the abuse. I've just asked a doctor for a full blood test because I'm so worried about it.
ellenbe WilRo
Posted
Hi Wilro, yes definitely still about. I have to say finding that chemist that didn't record was my total downfall. I just have to get back into the right headspace and start again. I'm definitely going to consider what you said about cutting myself off with the chemist. I think it might be my best option at the moment. If I can't get it, then the choice is taken out of my hands.
Regarding your drinking, did it escalate when you stopped codeine, or have you always drank the relatively same amount?
And please don't feel like Suboxone is the easy way out because it's not. It takes guts to make that decision so you should own that.
I will get back on track and will continue to post and keep you updated.
WilRo ellenbe
Posted
Hi Everyone,
I've just spoken to a producer from ABC Radio National. Tomorrow morning between 9-9:30am they are running a story about Codeine addiction on their Life Matters program.
I've been asked if I would speak about Codeine addiction on air. Although I'm fairly nervous about it I said yes.
The producer contacted me through this forum. Hopefully I can provide some benefit to the program even if it's minor. I think it will be an interesting segment, hopefully you guys will tune in.
Keep staying strong... And keep coming back here for support. The people in this forum have helped me so much and I really want to keep the momentum going for everyone else.
Oh, BTW my name will be Johnothon on the program.
Becky07 WilRo
Posted
I will definitely tune in! I'm sure your input to the program will be very interesting and beneficial to people listening
WilRo ellenbe
Posted
Apparently there's also a podcast available afterwards so if you muss us in the morning you can download it later. I'll post the podcast address here for anyone who wants to listen to it
Becky07 WilRo
Posted
WilRo Becky07
Posted
WilRo ellenbe
Posted
Hi Guys, so my link to the podcast has been moderated. I won't post the link again.
If you search for ABC Radio National and look for the Life Matters program you can download the podcast of the Codeine program.
Wilro
WilRo ellenbe
Posted
How are you all going, sorry I'm not naming everyone but the thread is getting quite large and difficult to address everyone personally.
I'm still going very well on my suboxone path. I think it's about 2 1/2 - 3 weeks now. I'm not counting any more.
I'm still not even thinking about Codeine at all. I'm so impressed with the medication I've chosen. I'll always have to keep repeating the fact that I'll still need to taper off suboxone at some point in the future but until then I'm happy with the fact my stomach, liver and kidneys will get a break and a chance to heal. That's in addiction to breaking the mental addiction to the process of visiting the chemist daily and going through the struggle of getting codeine products.
The thread seems to have slowed down a little. Don't give up, keep the determination going. If you need to look at options to assist like I did, just know that they are out there and I will help in anyway I can.
I feel so good at the moment I signed a contract on a new job today and this time I won't have to stop at the chemist on the way in, at lunchtime and on the way home.
Wilro
chris51572 ellenbe
Posted
Hi guys,
I am a community pharmacist in Perth. I have always had an active interest in codeine abuse/misuse even prior to the current regulation changes. First and foremost remember a pharmacist is your allie, even if we do not always give in to your demands. Very few occupations / people in this world will refuse something that makes them money. The current monitoring system (medsASSIST) and subsequent sale refusals has probably lost average pharmacies in the range of $20000 to $50000 in sales. But that being said the majority of pharmacists are still happy to lose these sales for the good of our patients health. Our mantra is first, do no harm.
Honesty is the best approach with the pharmacy profession. We are lied to day in day out and we have heard all the request pitches/reasons/excuses for codeine supply. Ask to speak to the pharmacist and request a private room (most new pharmacies are required these by law). We can only help with all the info. For example some people take codeine consistently for headaches/migraines whereby the codeine then becomes the cause of rebound headaches. Some people take codeine consistenly for real chronic pain, the codeine then can cause hyperalgesia a sydrome whereby the pain threshold is lowered actually causing more pain sensitivity. Then the last category of chronic codeine users are actually purely addicted and taking it simply to avoid withdrawals and remain feeling "normal". All of these require different approaches to solve the problem and we cannot even start until we know the true state of affairs.
I agree medsASSIST has been rolled out without a huge thought to those that may be suffering withdrawals due to supply refusal. But think of it this way, the pharmacists that are refusing your sale will generally be your more caring and motivated pharmacists. But laking the tools / referall networks to adequatley cater for an addict in need. But from your side rather than storming out and finding a pharmacy that just sees $ signs , stop and ask for a chat to the pharmacist. Even if it requires a private consult booked in at a later time. Here we can escape the busy pharmacy arena and you can open up and a plan can be devised. No good pharmacist will leave a patient suffering withdrawals without medical options.
I am happy to answer queries and hear feedback from your side. We cannot turn a blind eye to addiction and the consequent harm but we need patients to want to help themselves and trust in us.
WilRo chris51572
Posted
Hi chris51572,
Thanks so much for joining in on the discussion. Please stay tuned, I'm writing a response to you at the moment. It's going to be pretty big, so I have to type it up offline first so I don't lose it.
P.S please try and find the radio interview I did for ABC Radio National a couple of days ago. Posting direct links on this site does t work so it best if you can just search for the podcast. It was on the Life Matters program (Wednesday I think) but it was the program about OTC Codeine products
Wilro,
WilRo
Posted
ellenbe chris51572
Posted
Hi Chris,
It's great to hear the perspective of the pharmacist. You sound like you are knowledgable and care about the customer first and foremost.
So, you explained that honesty with the pharmacist is best. In the event we do explain we are simply addicted to codeine, wouldn't you just recommend us to see a GP? If this is not the case, then I'm interested in how you treat cases of codeine addiction.
You may have read that people's experiences in opening up to GP's about their addiction has had mixed results, so I'd be interested in other options.
Thanks again for taking the time to be a part of the discussion.
WilRo chris51572
Posted
Hi chris51527,
I should have my response to you posted tonight. I've been super busy the last few days with job applications/interviews etc which has ended up in me being offered my dream job. Yay, I've been working towards this outcome for years now and it's finally in my grasp.
My reply to you is quite large so I hope you'll hang around to read it and reply with your thoughts. We really do need someone like yourself here helping and answering questions. Please stick around.
Wilro
WilRo chris51572
Posted
Hi chris51572,
Thanks so much for joining in on the discussion. It's really great to have a pharmacists input including your personal and professional opinions on the topic.
I just want to add here, I did not initially envision this to be such a large post. As you are the first actual health professional (as far as I'm aware) who has joined us I just started writing, and writing. Sorry everyone for the length. As some of you know I really want to be active in this area and try and help people to not end up as I have.
Personally, this for me has ended up being an outlet for many things I'm thinking about including the legal action I will be taking against 4 different doctors in this post too. Sorry if anyone thinks it's a useless rant but I want to take this opportunity to lay it all on the line to the pharmacist who's reached out. It's people like him that can make a difference if hears a valid argument. I hope so anyway chris51572.
As you've probably read, there a quite a few people here who have been impacted in one way or another since the MedsASSIST program has been implemented.
I have one request of you first and foremost and I'm asking this because I have relationships with with quite a few different pharmacists (most good/some not so good) and I have experienced on a number of occasions pharmacists interpreting the new guidelines based on their own personal interpretation of them (because, currently that's what they are, guidelines only, there are no legal requirements to implement MedsASSIST) which some pharmacists choose to use as a way to deny not only people like me, but others as well without even considering the reasons people are requesting analgesics containing codeine. My request of you is to be honest regarding the laws vs recommendations and to try and understand things from our point of view and not just another addict trying to pull one over you.
The truth is, there are many people in Australia, who through no fault of their own have found themselves addicted to codeine unknowingly through the use of OTC medications to treat symptoms such as back pain, headache/migraines, tooth ache, joint and bone pain, fibromyalgia, nerve/neuropathhic pain and assortment of other valid reasons.
I don't believe anyone generally wakes up one day (unless you are a conscious drug user) thinking to themselves "Hey I want to get high today, I'll go to the chemist and buy some codeine containing drugs", 95% percent of people requesting analgesics with codeine are doing it for the right reasons which is to treat pain that a couple of paracetamol or Ibuprofen tablets will not help.
Unfortunately, after long term use to treat legitimate pain whether it's via OTC meds or after having surgery and being given pain relief medication in which hospitals and after care doctors generally don't manage well, people end up having to self medicate which sometimes results in people becoming unintentionally addicted. During the early stages most don't even have a clear understanding that addiction problems are developing.
People fall into the belief that after a while OTC Codeine products generally do make them feel better without making the connection between pain reduction and mild opioid euphoria.
This can also be tied in to people eventually using codeine (opiate) based medication in dealing with anxiety and depressive symptoms.
It's a slippery slope which I'm sure you understand. As far as I'm aware it's only recently (a year or so ago) that the 3 day use labels were placed on medicines containing Codeine.
The TGA's desire to make any Codeine containing medications Schedule 4 prescription only is unnecessary in my opinion. Prior to my addiction issues I used Nurofen Plus and Panadeine Extra responsibly and correctly for ten years and I can tell you that those medications were the only thing preventing me from heading to the emergency department on many occasions with severe migraine headaches. I'm certain many others started out for similar reasons. Due to the difficulty in discussing serious pain issues with doctors I had to resort to acquiring Physeptone (Methadone Hydrochloride) tablets illegally just so I had 3 or 4 tablets in my medicine cabinet for the times when my pain and vomiting was so bad I had bursted blood vessels in my eyes and probably brain.
If doctors and other medical professionals didn't treat everyone seeking stronger pain relief as drug seeking addicts (and refusing to supply or work with) then maybe a lot of these issues could have been dealt with much better by monitoring peoples use and assisting to taper off opioid drugs correctly rather than turning people away and leaving them to fend for themselves by purchasing OTC medication.
I know you're not a doctor, but do you realise how difficult it is to walk into a doctors office and request Panadeine Forte or a short (limited number) supply of Oxycodone?
I've had doctors tell me to continue taking Paracetamol after having already used 14 (or more) in 24 hours rather than providing a limited supply (for example, 3 tablets which they can do) of stronger pain relief.
I've even, just recently (while I was still taking huge amounts of Nurofen Plus) been told by two different doctors to continue taking up to 90 tablets per day, rather than them working with me on a tapering plan using Codeine Phosphate because in their words "Wilro, you've been doing it for years anyway so it's not going to cause you any more damage over the next month if you decide to quit". Both of these doctors knew that I suffered a perforated stomach two months prior to me asking them for help.
It's just completely disgraceful in Australia that doctors are more concerned with having to talk to the DDU (Drugs of dependence unit) and being listed as supplying a scheduled drug then they are about actually trying to help people.
We are drug addicts, we are not addicts in the same category as people who have consciously gone out looking to use Heroin, Oxy's, Roxy's or any other opioid based drug purely for the fun of it. We started of with legitimate pain issues and have been refused countless times by doctors who do make conscious decisions to put their duty of care away in the top drawer so they don't have to deal with it out of concerns for their own licenses and reputation.
My concern is the way in which the MedsASSIST program was devised and implemented by the Pharmacy Guild. Surely there were many years of documented evidence relating to the misuse of Codeine in Australia and the known issues in relation to the effects of stopping opioid drug use without the appropriate medical and psychological support.
I am very interested in the relationship between pharmacists and the pharmacy guild and am curious as to whether there are a few select administrators (decision makers) in the guild making decisions based on limited experience as opposed to the guild reaching out to the wider community of pharmacists asking for input into the best approach in dealing with the Codeine issue.
How are major decisions like this made?
Who is approached for for first hand experience of the issues?
Do pharmacists in the community have any input at all into guild decisions or do you simply pay fees to place a logo on a shop front window?
Although I am not a pharmacist, or even work in the health industry, I do have an active account with the PSA and have access to all the current guidelines.
I can tell you with certainty that there are many pharmacists who do not understand the new codeine supply guidelines and also a number of them experiencing a holier than thou approach to the situation simply because they wear a white jacket.
In your opinion, how should this have been handled? What would you tell an 80 year old arthritis sufferer who's been using codeine containing medicines for the last 10 years that she can't have it any more? Would you recommend Diflocenac knowing it's just as damaging to her stomach as ibuprofen?
Was there any training or assistance at all given to pharmacists prior to the change in regulations?
Something needs to be done and telling customers to see a doctor is a waste of time considering how incompetent doctors in Australia are.
What are your overall thoughts?
Wilro
WilRo chris51572
Posted
Are you coming back to the discussion?