Over the counter painkillers can be just as addictive as heroin

CODEINE, which is an over the counter (OTC) painkiller, belongs to a group of substances known as opiates, can be as addictive as heroin. It is derived from the seed of the poppy plant – also the origin of heroin and opium. Morphine, pethidine and codeine are all related to heroin. They affect the same receptor system in the brain and have the same effects, albeit in varying degrees. They are also just as addictive and habit-forming. Once ingested codeine leads to various effects, starting with a calming effect and progressing to a sense of wellbeing and sedation. In South Africa, codeine is available in pharmacies in the form of cough mixtures and painkillers, with the most commonly abused over-the-counter medications being Adco-dol, Lenadol, Betapyn and Propain, all of which can be obtained without a prescription. As a person gets more accustomed to taking these pills, the sedation gets more tolerable, and the euphoria and calming effects dominate.

When you take painkillers consistently three things happen in the brain:

The sensitivity to pain increases through rebound. So the more opiate painkillers you take, the more pain you experience.

The feel-good effect lasts for shorter and shorter periods, so you need to take more and more tablets to feel the effect.

Once it wears off, you go through irritability, mood swings and increased sensitivity to your normal stressors (withdrawal).

The World Pain Association defines abuse as taking more than eight to 12 painkillers in a month. On average most addicts take between six and eight a day.

Dr Salduker is a local psychiatrist and director of the Durban Pain Clinic at Netcare St Augustine’s Hospital.