Ireland’s Codeine Epidemic?

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EXCLUSIVE

CODE RED 

Inside Ireland’s hidden codeine epidemic as addiction expert reveals some people take dozens of pain pills everyday

  • 7:00, 16 May 2022
  • Updated: 8:24, 16 May 2022

An addiction expert has told how some people are ­popping dozens of painkillers a day — as The Irish Sun today reveals the country’s hidden codeine epidemic.

Dr Garrett McGovern told us: “I remember treating one man and I could see him in the waiting room from a distance, he was ashen. This guy was taking about 48 tablets a day. He had holes burned in his stomach.”

Our man Danny De Vaal was able to purchase ten packets of Nurofen Plus
Our man Danny De Vaal was able to purchase ten packets of Nurofen PlusCredit: Garrett White – Commissioned by The Sun Dublin
A probe by The Irish Sun showed how easy it is to get the codeine pain pills
A probe by The Irish Sun showed how easy it is to get the codeine pain pillsCredit: Garrett White – Commissioned by The Sun Dublin
Laura Newell died after becoming hooked on painkillers containing codeine
Laura Newell died after becoming hooked on painkillers containing codeineCredit: unknown

Authorities seem to have no idea of the scale of the codeine problem that is causing havoc for “thousands” of people who start out seeking basic relief from pain and end up in the throes of addiction.

The heartbreaking death of Sligo mum Laura Newell in January after becoming reliant on readily available painkillers containing the opioid prompted Tanaiste Leo Varadkar to warn of Ireland’s “hidden addiction”.

He told the Dail in February: “Somebody looking for codeine, Nurofen Plus, Solpadeine can’t just buy it. They will be asked questions by the pharmacist.”

But last week the Irish Sun went “codeine shopping” — and walked out of ten pharmacies with ten boxes of tablets

We tried ten stores in Dublin city and walked out with ten packets of Nurofen Plus.

While all asked whether the drugs were for our own use and warned against taking them for more than three days, just one warned about the side-effects of taking codeine.

Six asked whether we were on other medication or had taken Nurofen Plus in the past three days.

Seven offered us packs of 12 or 24, and we settled on 12 in every shop.

We could not tell in every case whether the person selling us the potentially addictive product was a pharmacist or a sales assistant.

EASE

The ease with which people can get access to codeine is, according to experts, only part of the story.

Data released to The Irish Sun by the Health Research Board revealed that 2,272 cases were treated for codeine as a main or additional problem between 2011 and 2020.

The number of cases soared by 57 per cent between 2011 and 2019.
The most common treatment was for codeine in combination with other non-opiate drugs (1,757 cases) and these include Nurofen Plus, ­Solpadeine and Solpadol.

Two thirds of cases were young people aged 18-34, while women made up two-thirds of cases.

‘DEVASTATING’

Addiction medicine specialist Dr McGovern estimates that just ten per cent of people with codeine issues seek treatment, describing problems caused by the misuse of Nurofen Plus as “devastating”.

The Priority Medical Clinic doctor happens to treat people largely from more affluent backgrounds who “present very well”.

But he has seen others dress up in smart suits and carry briefcases when visiting a pharmacy to pull off a more “legitimate” look.

And Dr McGovern warned how codeine mixed with paracetamol can damage the liver, while ibuprofen can cause kidney damage.

He added: “I want to be very clear, those medications are incredibly helpful to people who suffer acute pain. It is easy to sort of demonise pharmacies but the vast majority will just take them as needed.

“But there is a significant group — far more than is ­presenting for ­treatment — that is taking too much of this, taking it every day. Some are taking it for hangovers.”

He added: “I would say we’re probably only seeing ten per cent of what needs to be treated.”

ADDICTION IS SWIFT

Addiction, when it comes, is swift. Dr McGovern said most patients begin taking it for legitimate pain like migraines or menstrual pain but quickly develop tolerance.

He said: “What happened then? If it isn’t working they might increase the dose a bit and with those drugs there is a little bit of a buzz initially.

“Take more tablets, you get it more until unfortunately you develop tolerance, then you’re stuck.

“You know you can’t stop because you’ll get opioid withdrawal.

“Your heart coming is out of your chest, anxiety, loose stools, sweating and feeling really panicky.

“People don’t like that so they make sure they have plenty of them.

“This is one of those addictions – which is expensive by the way – where people are living a seemingly normal life. It’s very strange that way.

“It’s not like their life falls apart, it doesn’t happen with this.

“It can come to a head sadly when they start vomiting blood. Their kidneys start to get dicky. Sometimes it can be a surgical emergency when they get an acute abdomen from a perforated ulcer.”

THE ‘DOPESICK’ CRISIS IN AMERICA

MORE than one million people have died from overdose in the United States since the country’s opioid crisis began.

The scandal, captured in all its horror in the book and series Dopesick, is decades old and has seen three waves of addiction that has killed off generations of citizens.

It began in the 1990s with simple prescription opioids, the pill OxiContin aggressively driven by Purdue Pharma, capturing hundreds of thousands of people looking for pain relief in the grip of addiction.

From 2010 the heroin scourge emanating from this took over, before the rise of synthetic opioids – including the illicitly manufactured fentanyl – took hold three years later.

Only in 2017 was the epidemic declared a public health emergency.
Last year, 70 per cent of related fatalities involved fentanyl.

The Sacklers – the family behind Purdue – have agreed to pay out up to $6billion to settle thousands of lawsuits.

Purdue filed for bankruptcy in 2019, but the family took more than $10billion from it in the preceding decade.

Codeine has taken a terrible toll in the music industry, with many rappers developing problems with Lean, a mixture of cough syrup, soda and sweets.

Juice WRLD was 21 when he died in 2020 of oxycodone and codeine toxicity.

Dr Catherine Carney is treating a growing number of patients with codeine issues at the Delamere, a residential retreat in Northwich, UK.

But by the time people get to the clinic, the pain which kick-started their problem tends to be gone.

She told The Irish Sun: “That cleared up a long time ago, the ­initial pain was dealt with and they are now using it dependently for the feeling it gives them psychologically.”

PAIN PILL DEATH

Independent TD Marian Harkin raised Laura Newell’s case in the Dail in February on behalf of her family, who said her untimely death at 39 was because of her addiction to over-the-counter codeine meds.

Laura, who bought the drugs online, had been taking them as she had undiagnosed endometriosis — a painful gynecological condition.

The mum-of-two died after complications following bowel surgery for damage caused by painkillers.

Ms Harkin told us: “I believe we need to review our legislation in the context of the new information which is now available.”

A Department of Health ­spokesperson said: “We will consider taking any necessary further steps to support the safe and effective use of these medicines.”

Agreeing “without a doubt” that people are dying, Dr McGovern insists there are solutions out there for people.

‘TREATMENT AVAILABLE’

He said: “Treatment is available for this, through the HSE for free.
“We need to take responsibility in treatment services, we haven’t really created the awareness that there is actually really, really good treatment for this problem.

“We usually put people on Suboxone because a lot won’t want to be on Methadone.

“It works really well, a stronger opioid but it doesn’t have any ibuprofen, it’s just a generic opioid that lasts a whole day.

“A lot of patients want to stay on it, it keeps them away from over the counter things like Solpadene and Nurofen Plus.”

While Dr McGovern insists over the counter does not necessarily equal “innocent”, he does not believe they should be on prescription, believing it would overburden GPs and force patients to unfairly pay fees for pain relief.

He said: “The vast majority out there are using these very effective acute pain medications.

“I do think we need to pull together and think how do we create more awareness of not only treatment but also the dangers.”

A HSE spokeswoman told The Irish Sun: “We encourage anyone concerned about their own use or someone else’s use of codeine to consider getting professional support and not to try and manage their use alone.

“There are a range of specialised HSE funded drug and alcohol support services available nationally.”

Inside Ireland's hidden codeine epidemic as some take dozens of pain pills daily

 Pharmacy regulator PSI said: “Guidance obliges pharmacists to advise patients on the correct use of products containing codeine, while also ensuring that patients understand that these drugs are for short-term use only.”

Reckitt Benckiser, which makes Nurofen Plus, told us its product is continuously reviewed to ensure safety requirements are met.

Authorities do not have a handle on the true scale of the codeine crisis
Authorities do not have a handle on the true scale of the codeine crisisCredit: Garrett White – Commissioned by The Sun Dublin
JUICE WRLD has died age 21 of oxycodone and codeine toxicity
JUICE WRLD has died age 21 of oxycodone and codeine toxicityCredit: The Mega Agency
Leo Varadkar has spoken of Ireland's 'hidden addiction'
Leo Varadkar has spoken of Ireland’s ‘hidden addiction’

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