Long-term CODEINE use...? Is there any way to stop/alleviate bowel damage due to this? (Rather long Q!)?

I have been taking codeine 30mg, for over 10 years due to the pain of 'endometriosis' and have suffered with the associated bowel problems because of this. I have only been able to cut down on the codeine when pregnant, ( my doctor warned against stopping completely, as withdrawal may cause miscarriage).
Lately, I have been suffering horrific bowel cramps, sickness and other horrible symptoms (which I won't go into on here!)
I have been for the 'magic-eye' for the bleeding and pain, (the endometriosis caused the bowel to become 'stuck' to the uterus, and was separated surgically) which was inconclusive, but needs further investigation.
I am afraid to tell the doctor how bad it has got as he may stop giving me the painkillers (yes, looks like I'm addicted).
In the past, the pain has been so bad, the doctors have come out to give me 'anti-spasmodic, anti-inflammatory injections with morphine'. Today, bad pain again.
I'm scared that I've caused irreversible damage, what can I do
Answer:
I am afraid you are right, you are undoubtedly addicted. Last year warnings about addiction were finally added to the patient leaflets of over the counter packs of pain killers containing codeine.I have been fighting at local practice and at NHS Trust level about the mass prescribing of codeine based analgesics for more than 15 years without any real success. I have already vented my spleen in a number of earlier questions involving this drug.Nearly 80% of all paracetamol containing pain killers are now prescribed as ' Co ', codeine containing, formulations. There are also massive over the counter sales.This is despite many evidence based papers in learned journals, especially the BMJ. These papers all point out that though adding codeine to paracetamol does increase its analgesic potency by a modest 5%, its risks outweigh its benefits. It is addictive, produces severe constipation, headache ( called codeine headache and well recognised by neurologists) and abdominal pain. Ironically it is often used to treat the last two problems!There is an interesting geographical distribution of prescribing and over the counter purchase of codeine, I believe this demonstrates how its use is governed solely by prescribing habits, rather than clinical need. Prescribing is lowest in England and Wales, (though still huge), Higher in Scotland, Higher in the West than the East and highest in UK in Lanarkshire. (where I practice).To stand any chance you must go and talk to your GP about your problem and get help from him ideally in conjunction with the local community addiction team. This is not your fault, it is the effect of poor prescribing, this addiction to prescription drugs is a far larger problem numerically than that of street drugs and is, I am ashamed to say purely a consequence of how the medical profession prescribes. Most sleeping pill and tranquiler abusers have also been produced in this way, but they have a slightly higher profile than those with your problem.I apologise for using your unfortunate question to get on to one of my many soap boxes, but the medical profession as a whole, rather than your GP, who is just following current practice,which I believe is wrong, are to blame, and they owe it to you to help you out of it.

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I would say you need to be weaned off the codiene, it bungs you up so sudden withdrawal will cause IBS type symptoms which its sounds like you have. I am surprised they have left you on it for so long as it is so addictive, you made need to go on a mild sedatitive to help you along the way.

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codeine phoshate causes constipation a known side affect
I would of thought that after 10 years and still in pain you would need something stronger
it is only a mild analgesia
tell your doctor your problems and ask for better pain relief with out constipation

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It will take a lot of work and patience on your part, but you can help this problem. The first thing you need to do is work on the intestinal problem. Start taking immediately a powdered fiber supplement (no tablets or capsules) use Metamucil. Take this first thing in the morning with a large glass of water, and last thing at night. This is going to start gently moving the intestines. You're going to have to make a change in your diet because that is affecting your intestines. No more fried food, fatty foods,and junk food. You need to give your intestines a rest other then the fiber supplement. For now eat white rice, instant oatmeal, and white bread. This is to calm down the spasms. I know this sounds very harsh, but you have to break the cycle of spasms. I know because I have suffered from exactly what you have. Soluble fiber is the single greatest dietary aid for preventing spasms in the first place, as well as relieving them once they occur. Here's the kicker. Soluble fiber is NOT typically found in foods most people think of as "fiber," such as bran or raw leafy green vegetables. Soluble fiber is actually found in foods commonly thought of as "starches", though soluble fiber itself differs from starch as the chemical bonds that join its individual sugar units cannot be digested by enzymes in the human GI tract. In other words, soluble fiber has no calories because it passes through the body intact. As a general rule, the grain and cereal foods at the top of this list make the safest, easiest, and most versatile soluble fiber foundations for your meals and snacks.[1]Rice
Pasta and noodles
Oatmeal
Barley
Fresh white breads such as French or sourdough (NOT whole wheat or whole grain)*
Rice cereals
Flour tortillas
Soy
Quinoa
Corn meal
Potatoes
Carrots
Yams
Sweet potatoes
Turnips
Rutabagas
Parsnips
Beets
Squash and pumpkins
Mushrooms
Chestnuts
Avocados (though they do have some fat)
Bananas
Applesauce
Mangoes
Papayas (also digestive aids that relieve gas and indigestion)*Please choose a baked-daily, high quality, preservative-free brand. White bread does not mean Wonder.Why is soluble fiber so special? Because unlike any other food category, it soothes and regulates the digestive tract, stabilizes the intestinal contractions resulting from the gastrocolic reflex, and normalizes bowel function from either extreme. That's right 鈥?soluble fiber prevents and relieves BOTH diarrhea and constipation. Nothing else in the world will do this for you. How is this possible? The "soluble" in soluble fiber means that it dissolves in water (though it is not digested). This allows it to absorb excess liquid in the colon, preventing diarrhea by forming a thick gel and adding a great deal of bulk as it passes intact through the gut. This gel (as opposed to a watery liquid) also keeps the GI muscles stretched gently around a full colon, giving those muscles something to easily "grip" during peristaltic contractions, thus preventing the rapid transit time and explosive bowel movements of diarrhea as well. By the same token, the full gel-filled colon (as opposed to a colon tightly clenched around dry, hard, impacted stools) provides the same "grip" during the muscle waves of constipation sufferers, allowing for an easier and faster transit time, and the passage of the thick wet gel also effectively relieves constipation by softening and pushing through impacted fecal matter. If you can mentally picture your colon as a tube that is squeezing through matter via regular waves of contractions, it's easy to see how a colon filled with soluble fiber gel is beneficial for both sides of the IBS coin. As a glorious bonus here, normalizing the contractions of the colon (from too fast or too slow speeds) prevents the violent and irregular spasms that result in the lower abdominal cramping pain that cripples so many.I've enclosed a link to a website that can help you learn how to eat for your condition. If you would like more detailed information contact me,
Billie77

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Please, please, make an appt. with your dr. and tell him Everything you just typed here (with more details)! If you're having pain, he won't just stop your meds cold turkey, especially after this length of time. You probably don't want to hear this, but you may need another surgery, perhaps a hysterectomy. Please get treatment before you DO cause irreversible damage to yourself. In the meantime, take some stool softeners, eat plenty of fruit. And make that drs appt.!

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I'm surprised he hasn't tried to take you off it and put you on something different. There's many painkillers out on the market and some are good and some bad. Darvon was taken for a long time and you can get get it, but it's very easy to OD on that. Why not see another doctor who specializes in gastro-intestinal disorders.

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I am surprised your doctor has been prescribing codeine to you for so long. It is no wonder you are addicted. You would be best to try to stop taking these as soon as possible, and maybe try another painkiller if the pain is really bad. You will feel unwell for a while until the codeine leaves your system. In the meantime, please go back to your doctor regarding your endometriosis and tell him you want something done about this now. The pain you are experiencing could actually be more from the endometriosis than from the codeine. I suffered from endometriosis for fourteen years before doctors would actually listen to me. I have since had a hysterectomy, which I feel should have been done a long time ago, and I am now pain free. If you are offered this option you would be best to consider it as enometriosis has a way of returning time after time - as I found out to my cost. The pain, as you know is unbearable, but try not to make it worse for yourself by taking codeine which causes constipation as will add to your suffering. I totally understand what you are going through with this illness and my heart goes out to you. Don't let doctors put you off for any longer - it's you body, tell them you want something done NOW!!. Good luck girl. Hope you get well soon. x

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I myself became addicted to solphadeine (which contains codeine) after having back surgery. At one time i was taking 12 tabs of solphadeine a day in conjuction with other strong painkillers.
Two years ago in december i decided to calculate the amount of painkillers i was on per month and it came to a grand total of 635.
I knew i had to do something so i took it upon myself to start reducing my meds (without consulting my doctor/not good advice). I started by cutting out 1 solphadeine per day. I have to say that even with this small adjustment my pain went through the roof.
But i knew i had to do this for myself otherwise i would be addicted for life and my quality of life would be impaired.
It is a very slow and frustrating process but there is light at the end of the tunnel.
I still suffer from chronic back pain but i have managed to reduce my intake of meds to 270 per month.
I am still in the process of cutting down my meds.
What helped me were long hot soaks in the bath, a hot water bottle at all times, my family and some pain releiving gel.
I know what you are going through at the moment but let me say that you sound a very strong willed lady and you can do this.Best of luck and consult your doctor before you start reducing your meds.God Bless.

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You are NOT addicted unless you have been compulsively drug-seeking or continuing to take the meds despite negative consequences in your life (losing a job, divorce, etc.) or if you do not have pain anymore but are still taking the meds. If you genuinely need the meds you are not an addict. You are dependant on the drugs, but that is to be expected-- you have a disease, so you depend on meds to treat it. It is no different than a diabetic taking insulin, but no one calls them addicts. Your body had become used to the meds, that is ALL. Addiction is a behavior issue, dependance happens with ANY medication a person takes long-term. Don't let anyone scare you or amke you feel like a junkie; you re absolutely NOT one. Talk with your doctor about going to a pain management doctor, and don't feel like an addict. You have an illness, you take medication for it, that's all.

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First of all STOP believing all the people who say that you are ADDICTED to pain killers. You are NOT addicted.. you are DEPENDANT. There is a HUGE differance. If you are afraid that the doc w/ take you off the narcotics b/c you dont want to have to face life w/ severe pain then that is a VERY normal fear! If you are afraid he will take you off b/c you like the "high" or relaxation that it gives you then you need to think twice about the "addiction" part!!Ok.. NOW.. as far as the pain! You NEED to bite the bullet and go to your doctor ASAP! It sounds like you are having some MAJOR issues and if it IS because of the narcotics then you will unfortunately have to find a better solution for you.. but in the long run hun, dont you think it would be better to just get off of them and LIVE then stay on them when your body is refusing them and perhaps die!? It sounds as though you have been through a LOT in the pain department and I REALLY TRULY feel your pain!! You and your doctor need to sit down and have an HONEST long talk about what you need to now do to control the pain! It might be that he needs to seriously concider "upping" your dosage! Unfortunately because of the world we live in today there are a LOT of people who abuse narcotics and it makes it VERY difficult for people who ARE in horrible pain to get the relief that they so desperately NEED! If you are going to a doctor who makes you feel guilty or bad for needing pain meds when you ARE in pain then you need to do some research and find a new doctor who wont make you feel as though you are an "addict!" Take care and I hope that you will be in less pain tomorrow and in the days to come!

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It is professionally irresponsible for any clinician to prescribe you codeine any longer.. you should seek professional advice for your addiction with a view to withdrawing from your useage. It maybe a good idea to be referred to a pain management clinic so that this condition can be managed more effectively. If you carry on using this drug irresponsibly then you could cause damage to your body. Be honest with yourself and get some medical advice.

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I really suggest you contact The Caron Foundation in Wernersville Pa and see if they can refer you to a responsible pain management clinic. They are a rehab and you need a controled place that can detox you

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