Addicted to over-the-counter opium: Few realise codeine headache pills come from the same source as heroin - and evidence reveals more and more are getting hooked
- - A third of 18 to 24-year-olds take over-the-counter (OTC) medication daily
- - Members of Generation Painkiller often don't realise they could be addicts
- - Codeine, available in a variety of OTC painkillers, is a narcotic
- - Regular codeine users quickly become dependent on it
- - And the drug can be fatal: deaths related to codeine have tripled since 2001
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Every morning after breakfast, before Sophia Zepeda leaves the house for university, the 23-year-old knocks back something a little stronger than just a coffee to help her get through the day.
As she pops two Nurofen Plus tablets into her mouth, the law student says: 'It's a preventative measure. They give me the confidence that I can spend each day virtually pain-free. On other days, I take paracetamol and Migraleve.'
It may sound extreme, but Sophia, who lives with her parents in Barnet, North London, is part of Generation Painkiller, the phrase coined after a recent report found a third of all 18 to 24-year-olds in the UK take over-the-counter (OTC) pain medication daily.
Nine years of addiction: Sophia Zepeda started taking Nurofen Plus tablets aged 14 (right) after suffering from a series of debilitating headaches that plagued her adolescence
Take Sophia's pill-popping habit. She began dosing herself with painkillers aged 14, after the first of a series of debilitating headaches that went on to plague her adolescence. Her parents suffered from migraines and Sophia's GP decided she did, too.
But his recommendation, she says, to start taking codeine-based OTC painkillers saw Sophia unwittingly embark on an entirely legal opiate addiction, which still has her in its grip nearly a decade later.
Most of us have a packet of painkillers in our bathroom cabinet - but just because you can buy them in a chemist or supermarket without a prescription doesn't mean they're safe.
Few people realise that codeine, available in a variety of OTC painkillers, is a potentially addictive opiate - a narcotic, like morphine and heroin, derived from the opium-producing poppy plant.
And just this week, research showed that paracetamol-based Calpol - the most seemingly innocuous drug of all - could even be responsible for increasing rates of asthma in children.
'We certainly encounter significant numbers of people who do abuse painkilling medication,' says Nick Barton, of the charity Action on Addiction. 'It is an increasing problem.'
Sophia admits she would be very nervous about giving her tablets up: 'I still get headaches all the time but they don't progress to migraines very often and I'm convinced that's because I'm dependent on painkillers.'
Trapped: Aspiring novelist Rachel Sirotinina started taking painkillers when she was 16 to try and alleviate her stress headaches
Regular codeine users quickly become dependent, explains Fayyaz Ahmed, a consultant neurologist at Hull & East Yorkshire Hospitals Trust, and chairman of the British Association for the Study of Headache, because they soon find they need more and more of it to relieve the same pain.
'When they stop taking it they get withdrawal symptoms: irritability, insomnia, restlessness, sweating, anxiety,' he says. 'So they take more.'
There are restrictions - pharmacists are not supposed to sell more than one pack of 24 tablets of codeine-based painkillers at a time - so Sophia stocks up whenever she can: 'My bag is always filled with them. I feel panicky if I forget to put some in my purse.'
Stress is a major factor in Sophia's continuing usage - as it was for most of those interviewed for the report, who said they took painkillers to relieve tension headaches; almost half think their generation faces more stress than any other.
'There's a huge amount of pressure on my generation, to do well at university and then to get a good job and a mortgage - something that's never been tougher,' says Sophia. She lives with her parents and works hard to fund her studies, giving piano, maths and English lessons to children on the side.
'I can't let headaches stand in the way of my commitments or my future.'
That's a sentiment that Daniel Johnson echoes. When the 25-year-old events manager from Brighton began suffering from a bad back, that caused headaches and pain in his neck, he started taking codeine-based painkillers to allow him to carry on working.
Six months later, he's still taking them - despite the warning on the packets that they should not be taken for more than three days.
'They're a saviour in enabling me to get on with my job,' he explains. 'As an event manager I can be on my feet for 15 to 20 hours a day. The painkillers give me the peace of mind that I'll be able to do so.'
He recognises that he is now utterly reliant on painkillers: 'I imagined that the amount of codeine in the tablets I buy in the chemist wouldn't cause a problem, but I can't function properly without them due to the pain. I'm at a crucial stage in building my career and savings so that I can eventually buy a house.
'I'm devoted to my job and don't want to have to take any time off sick with a back problem. I feel that it's not something I should have at my age.'
It's an easy trap to fall into, as 34-year-old Rachel Sirotinina, an aspiring novelist from Durham, knows. When she was 16, her mother, eager to end her daughter's constant stress headaches, brought home a packet of Syndol, an OTC painkiller containing paracetamol and codeine.
'He was groggy, not his normal self, and I thought: “I take these things every day and this is what it does to a grown man?” '
They worked instantly, but quickly turned into a daily habit - and Rachel discovered that unless she upped her dose, her headaches got worse and worse.
Most days, she would take two tablets - on bad days, it could be four or six. But neither she nor her parents realised there was anything wrong: 'We didn't see it as a big deal. It was like taking a cough sweet or something,' she says.
Soon, the once bright and athletic teen became too exhausted to do anything. Whenever Rachel stopped taking it, her withdrawal symptoms left her anxious, sick and drained of energy - and, ironically, gave her more headaches.
She was 29 - 15 years into her dependence on codeine - before she realised the drug might be the source of her problems. 'My boyfriend, Nik, had a headache, and I said: “Oh, take a couple of my tablets.”
He took some and was absolutely floored - he fell asleep for a couple of hours and afterwards said: “How do you take these all the time? I feel terrible.”
'He was groggy, not his normal self, and I thought: “I take these things every day and this is what it does to a grown man?” '
Rachel's GP referred her for counselling - and when she confessed to taking a packet of Syndol a day, she was horrified to be told she was addicted to the codeine: 'I don't smoke, don't really drink, don't agree with drugs at all - I just thought they were innocuous.'
Rachel was then referred to an addiction treatment centre - where they proposed putting her on methadone, which is usually used to wean addicts off heroin.
'It was an immense shock,” she says. 'They were saying things like “When did you last shoplift?”, “How did you meet your dealer?”, and I'm thinking, “I go to the chemist! I've never shoplifted in my life. I'm in completely the wrong place”.'
Fighting it: Rachel, pictured here in her twenties when she well into her addiction, eventually went to an addiction treatment centre and mastered her dependency
And codeine can also be a killer. In the past decade the annual number of deaths in which some form of codeine has been implicated has almost tripled, from 46 in 2001 to 120 in 2012. That's not far short of the 154 deaths in 2011 caused by the opioid-like Tramadol, a prescription-only painkiller the Home Office is now looking at reclassifying as a Class C drug.
For doctors such as Fayyaz Ahmed, who see the consequences of such codeine addiction daily, the answer is clear - he would like over-the-counter codeine banned in the UK, as it is in the U.S. and many other countries.
Yet the government regulator says that it has never considered making codeine solely a prescription-only medicine.
And OTC painkillers are big business to the pharmaceutical industry. In the last year, sales of adult painkillers hit an all-time high of more than 25 million packs - at least 754 million pills.
Though Daniel and Sophia are still struggling to cut down their intake, for Rachel, hooked on codeine from the age of 16 to 29, there has been a happy ending.
Shocked by the suggested methadone treatment, she decided to go 'cold turkey' on her own: 'It was horrible, but it passed and I'm really glad I did it,' she says.
Deadly pills: The number of deaths in which codeine has been implicated over the past decade has almost tripled
'As the weeks went by the fog started to clear, the exhaustion lifted and, for the first time in 15 years, I started remembering what it was like to feel normal.'
Once a college drop-out who struggled to find a job, in 2011 Rachel celebrated by marrying Nik, the man who helped her kick the codeine habit. She has since completed a masters degree in creative writing, and is working on a novel.
'I can't believe I lost so many years to over-the-counter drugs,' she says. 'Now I just want to warn people about the dangers of medication. We all assume anything we can get over the counter is harmless, but that's not the case.'
Additional reporting by Sadie Nicholas.
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