Phoenix Acupuncture & Holistic Health

Pain Management without Codeine


Gwen James

Posted on 10:20 08/01/2018

John got chronic headaches. To prevent them, several times a day he takes paracetamol/codeine tablets. He's been doing this for years and refer to his tablets as "smarties". If John forget to take his smarties, he gets a headache - which he says proves he has chronic headaches. In fact, John is addicted to codeine and the headaches he gets when he forgets to take his "smartie" is the beginning of withdrawal symptoms. And John is not alone!

Restrictions on codeine products

At the moment, people can buy products containing codeine at over the counter at the chemist. These products include: nurofen plus, pandeiene, mersyndol, codral and demazin products (including cough syrup). But from 1 February, 2018 this will change and people will need to have a doctor's prescription to get any medication which contains codeine. This has been introduced because it is possible to become addicted to codeine.

Currently, many people, like John, take something every day which contains codeine. Many of these people have unintentionally and unknowingly become addicted to it.

We tend to think of people who have addictions as craving a substance which they take in large amounts. In fact, you can be addicted to as little as one or two tablets a day! If you compare it to a caffeine addiction, people who only have two or three cups of coffee a day may be addicted to caffeine but they have no idea they are until they try to stop drinking it! A friend of mine, who had two cups of coffee each morning, got headaches when she started to drink decaffeinated coffee - it was only then she realised she had become addicted to caffeine!

What happens when you can't get your daily codeine tablets?

People who have been taking codeine every day, particularly for a long time, run a high risk of being addicted to it. When they can no longer get it, they will have withdrawal symptoms.

Withdrawal symptoms may be quite mild such as: headaches, insomnia, muscle aches and pains and diarrhoea. Although unpleasant and painful, the symptoms usually improve within 72 hours. More intense symptoms include: vomiting, severe diarrhoea, severe anxiety, rapid heart beat, high blood pressure. These symptoms can be life threatening and often require hospitalisation.

The problem with withdrawing from codeine, especially if you have been taking a lot or for long periods of time, is you have no idea if you will experience mild or severe withdrawal symptoms. For this reason, it is important that talk to a doctor and get advice and possibly assistance for the withdrawal process. There are medications that can help you feel more comfortable during the withdrawal process or your doctor may recommend you withdraw under medical supervision (such as in a hospital).

What next?

Once you've withdrawn from the codeine, you may still have a problem: pain. Many people started taking the codeine product to manage pain such as a sore back or chronic headaches. These problems may reoccur once you stop taking the medication so it's important to consider some pain management process before you stop taking the codeine.

What are your options for pain management?

There are many options for pain management that you can consider - but they will depend on what exactly is causing the pain. Your doctor may recommend other medication to help you.

Other things that can often help include:

    Acupuncture - acupuncture is great for managing many different types of pain. Acupuncture treatment can be started before you stop taking codeine so you don't have a relapse of severe pain.

    Exercise - depending on what is causing your pain, exercise may help but strengthening the muscles and ligaments around the area. A personal trainer who is experienced in rehabilitation exercise is the best person to speak to about this - they can advise you of the best exercise for you and what to avoid. People often think that yoga or stretching is the best thing for pain but for some conditions it may actually make the pain worse so it's best to check before you start a program!

    Heat - a hot pack can be invaluable for pain. There are many disposable heat packs available on the market so you don't need to have access to hot water or a microwave to keep packs hot!

    Water - drinking water is essential to pain management. When the muscles and their covering, fascia, becomes dehydrated they become "sticky" and don't move freely. This can create more pain.

    Physiotherapy - A physiotherapist has a range of treats available to help relieve pain. Many good physiotherapists work together with an acupuncturist to provide holistic pain management.

    Massage - sometimes pain is caused or made worse by tight muscles. A massage can often help to release the muscles and provide relief.

    Relaxation - people in pain often find it difficult to relax and yet relaxation is essential to pain relief! Relaxation is very personal and may include listening to music, reading or spending time in the garden.

    Don't they say body and mind are important?

    What's happening in your mind is just as important as the things you do to physically help manage pain. Research has shown that negative emotions such as worry, anxiety, stress and depression can actually increase the pain you experience. Strangely, positive emotions such as happiness, gratitude and love seem to lessen the pain felt. Although it is difficult to feel happiness when you're in pain, concentrating on a enjoyable or pleasant moments can help. There are two little exercises that can help with this:

    • At the end of each day, write down at least one thing that you enjoyed or that made you happy. After a while, you will find that you go through the day looking for the happy or enjoyable things to write down!
    • The mind can only hold one thought at a time (try it!). When you find you're concentrating on something unpleasant such as the pain you're feeling, replace the thought with a more cheerful one! Maybe it's something your kids said, a joke you heard on the radio or a funny movie. Or it maybe a beautiful sunset you saw or the anticipation of an upcoming holiday. It doesn't matter what it is as long as it makes you feel good!

    Another thing that can help mentally manage pain is meditation. Meditation is often linked to mystics sitting on mountains and chanting mantras so doesn't seem very relevant to pain management! However, mindfulness meditation is a form of meditation which teaches people to be present in the moment rather than worry about the past or be anxious about the future. It has been shown to be very helpful to people experiencing pain. When you're totally focusing on what it happening at that moment, such as washing the dishes, it is difficult to also be worried about the pain you're feeling!

    Help is at hand!

    If you have been taking codeine regularly, it is important that seek help before the 1 February. Start with talking to your doctor about the possibility you may have unintentionally become addicted to the drug and what you should do. With that advice under your belt, consider alternatives for pain management. When the 1 February rolls around, you will be ready!

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