Co-codamol withdrawal.
Discussion
I know it's powerful stuff, it sent me doolally when I was on a max dose when I had spinal damage.
My MIL is (was) on it doc prescribed 2 per day to help with leg pains, she's been taking them for yrs. (leg pain caused by spinal stenosis in remission so much reduced, pain killers hardly req) She's 88, with heart problems, high blood pressure, and we think a recent TIA
Anyhoo, another doc has advised her to stop, just take some paracetamol as req. (along with a plethora of blood/heart stuff.
Since stopping, she's had diarrhea, restless leg syndrome, poor sleep patterns, nausea, and (existing depression which she won't take anything for) has been worse.
I know the obvious thing is to contact the doc. She's reluctant to do this, each time she does she's referred to the hospital, over the last 10 days we've spent so much time there whilst she's been messed about/examined/bloods taken and meds changed she's sick of the whole thing.
Is it likely her latest thing is caused by coming off Co-codamol? If so is just better to brave it out, cold turkey style?
My MIL is (was) on it doc prescribed 2 per day to help with leg pains, she's been taking them for yrs. (leg pain caused by spinal stenosis in remission so much reduced, pain killers hardly req) She's 88, with heart problems, high blood pressure, and we think a recent TIA
Anyhoo, another doc has advised her to stop, just take some paracetamol as req. (along with a plethora of blood/heart stuff.
Since stopping, she's had diarrhea, restless leg syndrome, poor sleep patterns, nausea, and (existing depression which she won't take anything for) has been worse.
I know the obvious thing is to contact the doc. She's reluctant to do this, each time she does she's referred to the hospital, over the last 10 days we've spent so much time there whilst she's been messed about/examined/bloods taken and meds changed she's sick of the whole thing.
Is it likely her latest thing is caused by coming off Co-codamol? If so is just better to brave it out, cold turkey style?
PositronicRay said:
I know it's powerful stuff, it sent me doolally when I was on a max dose when I had spinal damage.
My MIL is (was) on it doc prescribed 2 per day to help with leg pains, she's been taking them for yrs. (leg pain caused by spinal stenosis in remission so much reduced, pain killers hardly req) She's 88, with heart problems, high blood pressure, and we think a recent TIA
Anyhoo, another doc has advised her to stop, just take some paracetamol as req. (along with a plethora of blood/heart stuff.
Since stopping, she's had diarrhea, restless leg syndrome, poor sleep patterns, nausea, and (existing depression which she won't take anything for) has been worse.
I know the obvious thing is to contact the doc. She's reluctant to do this, each time she does she's referred to the hospital, over the last 10 days we've spent so much time there whilst she's been messed about/examined/bloods taken and meds changed she's sick of the whole thing.
Is it likely her latest thing is caused by coming off Co-codamol? If so is just better to brave it out, cold turkey style?
I was on the stuff for 13 years for a neck problem, but weaned myself off them but I was taking 8 per day, and once I stopped I had those you describe except for the nausea.My MIL is (was) on it doc prescribed 2 per day to help with leg pains, she's been taking them for yrs. (leg pain caused by spinal stenosis in remission so much reduced, pain killers hardly req) She's 88, with heart problems, high blood pressure, and we think a recent TIA
Anyhoo, another doc has advised her to stop, just take some paracetamol as req. (along with a plethora of blood/heart stuff.
Since stopping, she's had diarrhea, restless leg syndrome, poor sleep patterns, nausea, and (existing depression which she won't take anything for) has been worse.
I know the obvious thing is to contact the doc. She's reluctant to do this, each time she does she's referred to the hospital, over the last 10 days we've spent so much time there whilst she's been messed about/examined/bloods taken and meds changed she's sick of the whole thing.
Is it likely her latest thing is caused by coming off Co-codamol? If so is just better to brave it out, cold turkey style?
Co-Codamol causes constipation in some people which is why they suggest senna to help but once you come off the codamol then your body needs to re-adjust.
That was my experience anyway.
Just keep an eye on her and go to the Docs if nothing changes soon, took me about 2 weeks for the squits to stop / sleep issues about the same I think as it was a few years ago now. Cant remember about RLS and how long that took.
[quote=Allanv]
Co-Codamol causes constipation in some people which is why they suggest senna to help but once you come off the codamol then your body needs to re-adjust.
That was my experience anyway.
I concur with this. I was on them for about 15 years after originally being prescribed Pethidine for my kidney stones.
The Pethidine was quite addictive and I believe stronger, but the Codeine in Co-codamol 30/500mg is too. I was taking up to 12 a day before weaning myself off them.
Co-Codamol causes constipation in some people which is why they suggest senna to help but once you come off the codamol then your body needs to re-adjust.
That was my experience anyway.
I concur with this. I was on them for about 15 years after originally being prescribed Pethidine for my kidney stones.
The Pethidine was quite addictive and I believe stronger, but the Codeine in Co-codamol 30/500mg is too. I was taking up to 12 a day before weaning myself off them.
PositronicRay said:
I know it's powerful stuff, it sent me doolally when I was on a max dose when I had spinal damage.
My MIL is (was) on it doc prescribed 2 per day to help with leg pains, she's been taking them for yrs. (leg pain caused by spinal stenosis in remission so much reduced, pain killers hardly req) She's 88, with heart problems, high blood pressure, and we think a recent TIA
Anyhoo, another doc has advised her to stop, just take some paracetamol as req. (along with a plethora of blood/heart stuff.
Since stopping, she's had diarrhea, restless leg syndrome, poor sleep patterns, nausea, and (existing depression which she won't take anything for) has been worse.
I know the obvious thing is to contact the doc. She's reluctant to do this, each time she does she's referred to the hospital, over the last 10 days we've spent so much time there whilst she's been messed about/examined/bloods taken and meds changed she's sick of the whole thing.
Is it likely her latest thing is caused by coming off Co-codamol? If so is just better to brave it out, cold turkey style?
I am not a medic, but I have some experience in this area and have worked with people who've been dependent upon opiates.My MIL is (was) on it doc prescribed 2 per day to help with leg pains, she's been taking them for yrs. (leg pain caused by spinal stenosis in remission so much reduced, pain killers hardly req) She's 88, with heart problems, high blood pressure, and we think a recent TIA
Anyhoo, another doc has advised her to stop, just take some paracetamol as req. (along with a plethora of blood/heart stuff.
Since stopping, she's had diarrhea, restless leg syndrome, poor sleep patterns, nausea, and (existing depression which she won't take anything for) has been worse.
I know the obvious thing is to contact the doc. She's reluctant to do this, each time she does she's referred to the hospital, over the last 10 days we've spent so much time there whilst she's been messed about/examined/bloods taken and meds changed she's sick of the whole thing.
Is it likely her latest thing is caused by coming off Co-codamol? If so is just better to brave it out, cold turkey style?
Firstly, the doctor just taking her of an opiate and putting her on paracetamol was never likely to end well, if she has been on them "for years". But it happens often enough, GPs very often have limited knowledge of opiate withdrawal and there comes a limit to even what pain management specialists can do.
It is highly probable that the problems she is having is due to opiate withdrawal and at the very least she should have been tapered off them.
Everyone is different, and some people suffer more than others. But it's not uncommon for someone coming abruptly off opiates to feel very unwell for up to two weeks and then have two years of recurring bouts of symptoms. Insomnia can take a number of years to resolve, some claim never that their sleep has never resolved.
Aching teeth, muscles, face and flu-like symptoms are typical, as are jittery legs, flushing, loose bowels and insomnia. The culprit is norepinephrine, which was previously suppressed by the opiate, being released and causing an unpleasant stimulant effect.
If it were my MIL, I might suggest that she re-starts the opiates and ask for her to be referred to a pain management specialist to help her come off them in a more orderly manner. But, as I mentioned, sometimes even more specialist help can be required, in the form of drug and alcohol abuse specialists, who more normally deal with heroin addicts.
Specialists in that field will often use a different opiate, for example buprenorphine, to replace the original opiate and then taper off that. If the patient then experiences withdrawal symptoms a second drug, lofexidine, is used to mitigate them.
BUT, at it's a big BUT, at 88 I would question whether it is worth her going through the unpleasantness of addressing this problem. She will in all probability have died by the time she has fully recovered, and use of co-codamol is unlikely to be what kills her.
Feel free to PM me if you wish.
PositronicRay said:
Is it likely her latest thing is caused by coming off Co-codamol?
Yes.PositronicRay said:
If so is just better to brave it out, cold turkey style?
It's quicker to cold turkey, but at 88 why cause her more discomfort than necessary? I'd reduce the dosage gradually over a few weeks. If the pills are small and fiddly you could buy a pill splitter from Amazon.Thx.
I don't think pain management is a problem, it was, but she was taking the Co-codamol long after the pain eased. Spinal stenosis is cyclical, so likely to need them again at some point.
She seems to be bucking up, but can always try a 1/2 dose.
The trouble is she takes the docs words at face value, if the doc says take this she does, if doc says stop, she does. Currently she's not in the mood for any more doc/hospital visits.
Her GP is fairly useless, they'll only do telephone appointments, she's a bit deaf so always involves a 3rd party. Anything else is referred to the local hospital, they're not keen on having a third party in the consultation, so it's difficult to get a complete picture.
I don't think pain management is a problem, it was, but she was taking the Co-codamol long after the pain eased. Spinal stenosis is cyclical, so likely to need them again at some point.
She seems to be bucking up, but can always try a 1/2 dose.
The trouble is she takes the docs words at face value, if the doc says take this she does, if doc says stop, she does. Currently she's not in the mood for any more doc/hospital visits.
Her GP is fairly useless, they'll only do telephone appointments, she's a bit deaf so always involves a 3rd party. Anything else is referred to the local hospital, they're not keen on having a third party in the consultation, so it's difficult to get a complete picture.
Spoken to the doc (against her will) doc has confirmed she should have reduced gradually. She's OK with this.
She was taking 2x 30/500mg tablets in the evening, doc says it's OK to take up to 8 per day.
Thinking she should take 2 this morning, 2 more before bed, to build it up in her system. Then go back to 2 before bed each evening for a week, then reducing to 1 each evening.
She's not in the same pain as when she 1st started taking them, so pain management isn't the issue. It's the nausea and headaches (from the withdrawal we're hoping)
She was taking 2x 30/500mg tablets in the evening, doc says it's OK to take up to 8 per day.
Thinking she should take 2 this morning, 2 more before bed, to build it up in her system. Then go back to 2 before bed each evening for a week, then reducing to 1 each evening.
She's not in the same pain as when she 1st started taking them, so pain management isn't the issue. It's the nausea and headaches (from the withdrawal we're hoping)
PositronicRay said:
Spoken to the doc (against her will) doc has confirmed she should have reduced gradually. She's OK with this.
She was taking 2x 30/500mg tablets in the evening, doc says it's OK to take up to 8 per day.
Thinking she should take 2 this morning, 2 more before bed, to build it up in her system. Then go back to 2 before bed each evening for a week, then reducing to 1 each evening.
She's not in the same pain as when she 1st started taking them, so pain management isn't the issue. It's the nausea and headaches (from the withdrawal we're hoping)
If she has been off them for a while she may feel nauseous initially, but quite quickly feel better. It's then a matter of whether she tries to taper off or just modulate the dose as and when necessary.She was taking 2x 30/500mg tablets in the evening, doc says it's OK to take up to 8 per day.
Thinking she should take 2 this morning, 2 more before bed, to build it up in her system. Then go back to 2 before bed each evening for a week, then reducing to 1 each evening.
She's not in the same pain as when she 1st started taking them, so pain management isn't the issue. It's the nausea and headaches (from the withdrawal we're hoping)
An aside regarding taking them at bedtime; there's nothing wrong with that, but they will have a hypnotic effect. So if she does decide to come off them she will have the double whammy of withdrawal and also the absence of a sleep-inducing crutch. She may struggle to sleep.
But, as we have discussed, a lady of her age may decide that having opiates in her life for her remaining tenure may not be the end of the world.
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