Confessions of an opiate eater!

By KomodoMK · Sep 17, 2008 · ·
  1. KomodoMK
    There is much debate, yet again, around the decriminalisation of drugs in the UK. It's a debate I find confusing. I can already stroll into many pharmacies in the United Kingdom and buy a fairly hefty dose of morphine for under two pounds. And it's legal.

    I'm talking about codeine linctus, which is sold as a cough suppressant. Many pharmacists no longer sell this product, but all can if they wish. If you know where to go, you can buy a 200ml bottle for around £1.80. Some "friendly" pharmacists will even sell you more than one bottle at a time, although, in my experience, they bump the price up to around £3.50 a bottle.

    One 200ml bottle of the medicine contains 600mg of codeine. Codeine is converted into morphine once ingested, and this 600mg ends up as equivalent to about 90 milligrams of morphine. Taken orally, this has about the same effect as taking 20 to 30mg of morphine intravenously. If you fall over in the street and break your wrist, you might get injected with 10mg of morphine IV in the casualty department. So, just to reiterate, for less than two quid, at many pharmacies in the UK, right now, you can buy a dose of opiate analgesia that's about three times as strong as you'd get if you broke your wrist.

    Opiate drugs (by which we mean morphine, codeine, dihydrocodeine – basically anything which has its roots in the opium poppy) are already legally available in this country.

    Codeine linctus is probably the "gold standard" for people like me, addicted to OTC (over-the-counter) medicines. But it's far from the only way of getting your dose of drugs. Much more readily available are the combination painkillers. My personal favourite has for years been Paramol, which is mainly paracetamol, but also has a shot of dihydrocodeine in each little, white, easy-to-swallow torpedo. It's marketed as the strongest painkiller you can get without prescription ("You Can't Hit Pain Much Harder" it says on the pack), which it is, although there are plenty of other very similar ones available. Most contain codeine as the active opiate rather than dihydrocodeine, and the maximum dose is 8mg of either. Dihydrocodeine is usually quoted as being about twice as potent as its shorter-named cousin, which is presumably why Paramol is the market leader. Although Boots now produce a pharmaceutically identical own-brand product for about a third of the price, I still prefer Paramol with its reassuringly dramatic black packaging. At times over the past decade or so, I have been necking as many as 60 Paramol a day. According to the text books, my liver should have shrivelled and died after a couple of days of such abuse (it's the paracetamol that does this to you), but mercifully, mysteriously, it has survived, though it did have an especially rough period for a few months and needed its own brief spell in rehab.

    When you're getting through that many tablets, there are practicalities to overcome. Not least is the cost: at around £4.50 for a packet of 32 tablets, I was spending £200 to £300 a month on the stuff. Maybe not that impressive when weighed against a heroin or crack cocaine habit, but a significant chunk of my income. Then there is disposal of a hell of a lot of packaging – the car boot wasn't actually crammed full, but I wouldn't have wanted to open it in front of anyone. Finally, there's the rotation of chemist's shops; you can't go back to the same one every day. Changes to pharmacy opening times a few years ago were a blessing of sorts. Before, they all closed at midday on a Saturday and didn't re-open until Monday. Now a lot are open on Sundays and some are accessible 24 hours a day.

    The miracle of my liver's survival is all the more startling to me as I work in "the business". As a dentist, I know a bit more about teeth and gums than livers, but they do teach you something of what paracetamol does to your insides at dental school. Doctors and nurses are quite well known to develop addictions to drugs obtained through their work, and while it is possible for dentists to have similar problems, access is more limited. But I think the main reason I chose the local pharmacy over the practice drug cupboard is the paper trail. Especially since the Shipman case, if you get caught doing anything illegal with drugs as a medic or dentist, the consequences are likely to be dire. But I could buy as much codeine or dihydrocodeine as I liked from various different pharmacies, the only consequences being those on my mental and physical health.

    Which, I suppose, brings us to why I started doing it in the first place. I have been asked more than once questions like "Why do you take the tablets?" and "How do they make you feel?" In answer to the first, you may as well ask why I breathe in and out every few seconds. It had just become the way I functioned, and certainly the way I coped with the stresses of life and work. I wanted to scream back at the questioner, "Why aren't you taking something?" (if, indeed, they were not). I found it difficult to believe that someone could manage their daily living activities, and take their work as seriously as I did, without some kind of pharmaceutical prop.

    As for how the tablets made me feel, "insulated" is the word I most often use. It was as if I was encased in a layer of bubble-wrap when dosed up with codeine, or Paramol.

    I think I first started to use the drugs for legitimate reasons – backache, as I recall. I cannot now remember if they cured my back, but they made me feel warm and confident. And so, as they say, it begins. Over the next 10 or so years, the habit came to dominate my life, but in such a subtle and insidious way that I came to see it as part and parcel of my life, rather than as any kind of intruder.

    Addiction to OTC drugs is a very private affair. While celebrities end up in the papers and in the courts after partying all night, and non-celebrities gather together to celebrate their destructive habit, people like me skulk around in chemists' shops, hoping that we are not recognised from a few days before, (and in my case, hoping that none of the local pharmacists get a bad tooth), before downing some tablets in complete privacy. Or sometimes not. One day my girlfriend caught me out. It turned out she'd seen me taking tablets before, and it was obvious that the amounts I was taking were far more than it is usual to take for aches and pains. I promised to get myself sorted out, and she, I'm very glad to say, promised a while later to marry me. Unfortunately the "getting myself sorted out" bit took a while longer than I had promised.

    Holidays, although somewhat problematic when you have the condition I have, do serve to highlight the twisted attitude to opiates we have in this country. For years now, I have had to smuggle Paramol into my holiday destinations and try to ration myself, usually dashing off the plane at Heathrow or Manchester as soon as I land back home in the hope that the airport branch of Boots is still open. In the Caribbean, for example, availability depends on local history and culture. Bonaire or Tobago – no codeine. In Barbados, stuff similar to Paramol, but called Remedeine, is freely available. In the mainland United States you cannot get anything with a trace of opiate without a doctor's prescription, and can almost get locked up even for asking.

    The same Puritan attitudes apply in countries with an Islamic tradition, such as Egypt, where your request for codeine-based products, even in an English-speaking pharmacy, is met with the response "that is classed like drugs here". Of course, if I was a "real" addict, I would spend my time in Los Angeles, or Sharm-el-Sheikh, or Mauritius, or Turkey, trying to score some street heroin. Thankfully, while being hooked on headache tablets is a royal pain in the arse, it is not quite as much of a pain as some other addictions.

    No one knows for sure how many people in the UK are addicted to OTC painkillers, although at a British Medial Association conference in 2005, the figure of 30,000 was given. I would be surprised if it were really that low. Many who do have the habit would not even think of describing themselves as addicts. But mainly, figures are impossible to come by because of the completely unregulated way in which opiate-based analgesics are sold. It's an issue that raises its polite, British head now and again – often as a result of personal stories like this one. A few years ago, I heard a spokesman for the pharmaceutical industry say that the amount of opiate in the various products whose manufacturers he represented was so tiny, that he could not believe anyone could become "addicted" to them. Well, smug boy, if they're that tiny, why include them? Let me answer that for you. The opiates are included because they make people feel nice, and they earn the pharma trade millions of pounds every year.

    If I sound a tad bitter, it's because I'm entitled to be so. After years of planning my days around trips to local chemists' shops, I am finally free. It has been a rather enforced freedom, following on from a confrontation at work. Once again, the supposed secrecy of my habit was not quite what I thought. Not only had I been seen taking tablets, I had also been seen going into local pharmacies. A lot. Neither a crime in themselves, but the result was that I was "offered" the chance to take a period of sickness absence, and get well. Which is what I'm doing.

    Ironically I have, in part, the pharmaceutical giants to thank for this breakthrough, because I now take a daily tablet called naltrexone, which has the strange effect of blocking the effect of all opiates on my body. The main downside is that if I am unlucky enough to fall and break my wrist, morphine will be completely ineffective. The main upside is, well, everything else. And by that I mean everything – tastes, smells, sights and sounds, sex, sunshine, searing hot showers. Everything is more intense when my ex-best-friend Paramol is away. I've always had a habit of shedding a tear at seemingly inappropriate moments, such as a particularly poignant judgement on The X Factor. Now I simply blub like a child, which is a source of unending amusement to my lovely and long-suffering wife. It's been a scary ride though, involving sleepless nights, much diarrhoea and some vomiting.

    But I still miss my friend terribly sometimes. For years, codeine has been there to hold my hand when times are rough, and fight my enemies for me. It's as if someone has taken away a lovely, fluffy, blister-pack security blanket (look at chat-rooms on the topic, and you'll find that it is not only me who refers to their tablets in these terms). It has left a huge gap in my life, one that will be hard to fill with something more healthy.

    Without doubt, the weirdest side-effect of quitting painkillers is that I'm in less pain. I used to get the occasional deep sports massage on my back, and it was agonising. I had huge areas of tense, knotted muscle which when massaged would make me yell out in pain. Within three weeks of stopping the Paramol, they had gone, helped on their way by two visits to a hopefully non-habit-forming Chinese therapist. He said that painkillers were bad as they merely masked the pain and made my muscles even more tense and diseased. There is a recognised condition called "analgesic headache" which is caused by taking too many painkillers. But with drug companies making so much money from analgesics, and with those same drug companies providing almost all of the funding for medical research these days, don't expect proper research into whether painkillers actually make pain worse any time soon.

    As hinted at earlier, I really don't know how I feel about where we should go with OTC opiates. Undoubtedly, they are not needed to treat pain; the United States demonstrates that. Up until now, the only time over many years I have ever been at least temporarily free from codeine is when holidaying in the US. We could easily do the same here – have absolutely nothing but plain paracetamol and ibuprofen available without prescription. But I also know how personally disastrous it would have been for me a few months ago had someone cut off my supply. The sad fact is that thousands of people in this country need opiates to be available without prescription. Not necessarily to treat their pain, but to allow them to function. To suddenly cut off that source would not only be cruel, it would end in tragedy for many.

    Take the argument further in the other direction and we could probably improve the health of dozens, perhaps hundreds of people by making pure codeine more freely available, without the liver-mulching paracetamol. It sounds attractive, only I know that I would simply have taken more and more codeine until it had little noticeable effect (tolerance of opiates is one of the reasons they are so dangerous.)

    Rather than changing the regulations, what we really need, and need desperately, are more treatment services. Services for the treatment of OTC addiction are virtually non-existent, perhaps not too surprisingly as there is little if any crime associated with the problem, so even less political pressure. Addiction services in general are over-stretched already, and likely to have little time for someone whose habit does not involve needles or probation officers. As a health professional I had a hard enough time finding help, and it's still a struggle. My rapid detox came courtesy of a consultant psychiatrist, but ongoing treatment still has to be finalised. There are a few fairly random services aimed specifically at dental and medical professionals with addiction problems, but my experience with these has not been good. A few years ago I rang one helpline on an evening when I was feeling particularly in need of help. Unfortunately, the person answering sounded so drunk I could not fully understand their advice.

    For others, especially those who have drifted into addictive patterns by complete accident, who simply wake up one morning and realise they can't go to work without a few of the headache pills for the headache they no longer have, finding help can prove impossible. The only service dedicated to OTC addiction of which I am aware is completely voluntary, and funded (only just) by donations.

    I am not by nature a preachy person. And even less inclined to preach knowing as I do the risks of relapse with this condition. But a little preaching may be in order, if only to say that if you do take more painkillers than you know you need to, you can get help. Finding someone to take you seriously is the first step. If you're lucky enough to do that, then take it from me, the rest can be done.


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  1. G_nome
    SWIM used to do such things, even going to different towns and several chemists, stocking up on paramol. This he done for about a year, after he got clean from his IV heroin use and before he discovered pods. Though he was wise to always do a CWE. Even the "logo" of paramol looks like a constricted pupil to SWIM:

    G_nome added 4 Minutes and 23 Seconds later...

    Can you see it?
    Though SWIM only usually kept this to a weekend habit, a wee treat at the end of the week.
    It's also possible to buy morphine and opium tincture OTC in this country, at a very reasonable price too. But you need to be old, it seems, for a chemist to sell you that stuff.

    Good post komodoMK.
  2. cra$h
    wow. you guys are soooooooo lucky. In the U.S. if you break your wrist, they say take a tylenol. We have some pretty high pain standards for opiates, which is really ashame because they're harmless and work so damn well.....
  3. nikky36
    done the whole chemist thing as well,i think its ridiculous how some over the counter medicines are banned but anyone can buy as many paracetomol as they like from as many different chemists and we all know how deadly this can be in an overdose............
  4. W!SE
    swim thirds that . he was recently overseas (away from home,USA) in Barcelona, Spain. He had learned from this forum prior to the trip that codeine would be available. His imagination told him that there would be a bunch of medicine everywhere (otc) and swim would b able to read ingredients and select the best ones for CWE...however it was a lil diff but luckily from the forum swim learned someone in spain bought a cough medicne TOSEINA (tose = cough, codeina = codeine) lol each time he walked out with the stuff it was a rushhh like a drug deal just went down it was awesome.

    swim has never seen so many pharmacies ever in his life...all the same company, literally across the street from each other EVERY SINGLE BLOCK it's like they want people to abuse

    he remembers putting the shit into a flask sipping on it while skateboarding...and also mixing it with the oxycodone he brought with him. it sucked when his oxys were running out and he had to rely on the codeine. in a way it saved him from wd's so its all good.

    swim on
  5. fiveleggedrat
    I hate the US. I hate that here, everyone is stuffed full of garbage like acetaminophen and the government tries to police everyone's fucking life, telling us the proper medical treatment for any and everything, even superseding the medical community's stance.

    I know lots of people, going into the ER with broken bones, and walking out with a script for...Tylenol! How smart.

    My friend broke his foot last week. He was in bad pain too. What'd he get? Tylenol. Another friend was in a car accident, broke about every bone in his face. What'd he get? 10 Vicodin 5mg's.

    That's ok, smarties, thankfully the streets still bleed with heroin, just not enough.
  6. KomodoMK
    I noticed this when I went to Lloret de Mar near Barcelona with my best friend this year and I went to get her some heartburn tablets. The odd thing was that all the pharmacys were closed all the time we were there. Eventually a police officer see me trying to work out the Spanish sign on one of them and guided me using a map to one that was open - quite difficult as we couldn't understand each other. Maybe the majority of them are closed during peak holiday season?
  7. Pope Albacore
    SWIM reads this and once again shakes his head at the level of intolerance and ignorance in the US. If SWIM asks for any opioid to ease pain in an ER or from a MD besides his own he gets the "look" and often a lecture. SWIM knows that many times doctors are WAY too quick to describe a person in pain as having "drug seeking behavior". The idiocy confounds SWIM.

    -Pope Albacore
  8. W!SE
    siesta..a time during the day where (almost) everything closes for about 2 hours.. barcelona is sick tho geez
  9. KomodoMK
    Nope, wasn't that - when everything else reopened the Pharmacy's never did, except for one main one on the resort which was hidden away in a back alley.
  10. G_nome

    Well they're not that good at prescribing strong painkillers over here either, in SWIM's experience. But at least people have the choice if they wanna go and buy these meds without a script.

    A few years ago SWIM got attacked with a knife, nearly getting his nose completely chopped off and having to go through a few hours of plastic surgery to reattach the nose.
    Upon leaving the hospital, where he spent the weekend getting nicely doped up on morphine, dihydrocodeine, tramazepam and various other things, ye know what they gave SWIM? IBUPROFEN!!! :confused:

    Luckily SWIM had some nice friends that sorted him out with some proper pain meds.
  11. cra$h
    and that's the sad part. legitimate pain poorly managed, and then you get law abiding citezens forced into a black market, where they don't belong.
  12. Dickon
    I'm lying (or am I? you decide) when I say...

    I can sort of relate to KomodoMK, in that I developed my first habit on OTC opiates. But I had taken speed, and dope, and about the same time I injected speed and took acid, so I wan't partial to legality. My OTC drug of choice was Dr J. Collis Browne's Mixture, and I'm simply shaking my head at the lucky-livered who are wolfing down the dhc-paracetamol (that's apap/acetaminophen to those over the pond) and codeine-paracetamol combos by the handful. Either your very lucky, or the conventional wisdom on paracetamol is wrong. Codeine linctus is pretty hard to get over here, but Collis Browne's mixture isn't. It is significantly more expensive being about £5 a bottle. Each bottle contains 20mg morphine in 100mg of brown syrupy gack. It tastes pretty vile, but 2 bottles would send me to opiate heaven, and I'd rate 2 JCBs over 200ml of codeine any day, simply in terms of quality of effects. Personally I'd rate 600mg codeine = 60mg morphine, but codeine is metabolized differently by different folks. In later instars of my life I injected heroin and took oral and i/v methadone, but the two times I've relapsed after quitting opiates for over a year each time have been on good old legal J. Collis Browne's mixture. If you like morphine and have a robust stomach (this stuff contains ipochac and a lot of alcohol) Gee's linctus is available with 32mg morphine for about £2. But this stuff is all-but-undrinkable, so I'd only buy it as a last resort. There are some other silly low dose morphine tablets with 0.3mg in some clay base. One can filter them, but it's totally expensive and inefficient.

    None of the morphine based products in the UK have any real medical uses, or any medical uses that are not served better by other products. Well Collis Browne is great for pain if you drink two bottles, but that's not the recommended dose, or the recommended reason to take it! I think it's somewhat anacronistic considering the nanny-state we live in here, and as far as I know the maximum allowed dose in otc preps (1mg morphine anhydrous - 5 ml) has been reduced over the years. I know for sure this happened at least once. There are occasional campaigns to ban these things. The way Britain is going, I'm pretty sure this will happen sooner or later.

    To people like me this could be a blessing, but chances are it would have just delayed my opiate addiction until I found heroin.

    Dr D
  13. KomodoMK
    This was a news post, my little fishy has never tried Heroin and doesn't intend too. Also you need to check the rules regarding self-incrimination and edit your post before someone negative reps you.

    They can be found here:
  14. Dickon
    Read my post again - I'm covered for self-incrimination. The first line might give you a clue. This method works for Alfa, it ought to work for you.
  15. jon-q
    Firstly let swim explain that he has a great deal of respect for swiy komodoMK,In fact swim would consider swiy to be a cyber freind!
    Swim is also aware that swiy komodo will have invested a great deal of time writing out the above report with the best of intentions to DF.
    So let swim make it clear~This statement is aimed at the original source and not swiy komodoMK..
    Fact codeine is available OTC in the uk,it can only be purchased in a pharmacy/chemist and one has to ask the chemist for said medications and the buyer will normally be asked a number of standard questions(what is the medication for,have you used this medication before,e.t.c)Although very rare,The chemist can refuse to sell swim this medication!
    Secondly and the main reason for this reply~codeine is metabolised into morphine via the CYP2D6 enzyme,this conversion rate is between 5%-10%.
    Codeine does have the analgesic strength 8%-12% of morphine,this should not however be confused with the codeine-morphine conversion ratio.
    Another factor to consider is that codeine has a ceiling level of around 400mg-450mg,and the final nail in this coffin is the oral to intravenus conversion ratio of morphine which is approx 4 times:ie 4mg oral morphine = 1mg IV morphine.
    So fellow swimmers lets do the sums and we will assume all conversion ratios to be the maximum and we will ignore the ceiling level.
    600mg codeine = 60mg morphine = 15mg IV morphine .This is not 20-30mg and if we were to use the mean ratios and include the ceiling level the actual amount would be 8.435mg IV morphine.
    Now you may think that swim is nit picking and maybe he is but it is scare stories like this that will end up leading to OTC codeine products being banned in the uk!
    SOURCES .pharmaconetic drug Intractions,wikipedia,nationmaster,
    As said respect should be given to swiy komodomk for posting this article in the first place.
  16. KomodoMK
    Not sure if that is a decent disclaimer, regardless it's good practice when using disclaimers to highlight them in bold or put emphasis on them in another way and place them at the top of the post. That way people won't get confused and comment in the way I just have.

    The advice I just gave I was given by a mod myself when I posted an experience report for my little fishy and used a similar method as you.
  17. Dickon
    I do find it a little ironic that you are targeting me for self-incrimination, when in fact in the initial post of this thread it looks to me like you are self-incriminating. I was told that the legality of the drugs in question was not the issue, so perhaps technically speaking selfinCRIMINation is slightly misleading. But thanks for the heads up. I am sorry if my post upset you, but I'm still slightly confused as to why. It was as much a mix of IM-personal and factual opinion as yours was, or so it seemed to me. Perhaps you could PM me with where I crossed the line in your opinion. The last thing I want to do is to do as a new member here is upset anyone. Sorry if I did you.
  18. KomodoMK
    Thanks Jon-Q, appreciate the comment! The feeling is mutual. :)

    Very good point you have just made there, I failed to pick up on that when I read the article the first time myself. Unfortunately journalists don't take the time to properly educate themselves and check their facts in relation to what they write about and in most cases the article wouldn't have their desired effect if they did.
  19. G_nome

    SWIM always done a CWE whenever he got paramol.
    Also, there's generic forms of j collis browne's mixture which are MUCH cheaper if SWIY shops around.
    SWIM once tried to get a bottle of the infamous j collis browne mixture from his local chemist and they tried to palm him off with stuff that relieves constipation! Either they was having a laugh or were just stupid chemists.
    Thank goodness for online chemists when times are hard, SWIM says, much cheaper and no failed doctor of a pharmacist asking SWIM loadsa questions or telling him "we don't sell that", aye right.
  20. Dickon

    Generic J.C.B.? I think you are mistaken as this is a totally proprietary formulation. If I am wrong, please support your claim with manufacurer, and product name. The only thing I think you might be talking about is Kaolin & Morphine mixture which is listed in the BP(British Pharmacopoeia) [verified from BP 1999] so is manufactured generically. This is much cheaper but a totally different product.
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