Sunday, September 5, 2010

EXPERTS WARN ON ADDICTIVE PAINKILLERS

Danny Rose, AAP September 5, 2010, 12:35 pm

Addiction to household painkillers is a serious problem with major health impacts, according to an Australian study of people taking up to 100 painkilling tablets a day.

Misuse of over-the-counter analgesics was the "third-most common category of substance abuse in Australia after cannabis and ecstasy", with more than half a million Australians hooked.

Research published in the Medical Journal of Australia has detailed the cases of 27 people addicted to codeine and ibuprofen-based painkillers - typically Nurofen Plus - and the damage this caused to their health.

The side-effects included gastrointestinal ruptures, renal failure, anaemia and severe hypokalaemia - low potassium in the blood that can cause an irregular heartbeat or paralysis.

An addiction expert and senior lecturer at Monash University's School of Psychology and Psychiatry, Matthew Frei, warned that although codeine could be considered a relatively weak opioid analgesic it was nevertheless addictive.

"The significant morbidity and specific patient characteristics associated with overuse of (these painkillers) support further awareness, investigation and monitoring," Dr Frei said in an article.

The 27 patients either sought treatment for opioid addiction or were referred to a hospital addiction service in Australia from 2005 to 2008.

There was an even split between men and women, and most had no previous history of substance abuse.

Dr Frei said the patients commonly reported taking painkillers to treat a chronic ailment, and then falling into a pattern of daily use and multiple packets.

"A significant proportion of patients reported initiating use of over-the-counter ... products for painful conditions, including back pain and headaches, and subsequently escalating the dose," he said.

"A mean dose range of 34 to 47 tablets per day was reported in this case series," he said, while adding that one patient was taking up to 100 tablets a day.

All of the patients were put on a methadone or equivalent withdrawal program to break their addiction.

While the cases gave no indication of the prevalence of painkiller addiction in Australia, Dr Frei said it highlighted the need for increased scrutiny by the medical community.

"Given that these drugs are likely to remain available without prescription in Australia, physicians should ask specifically about non-prescribed analgesics when taking a medication history," he said.

"Pharmacy personnel should consider the risk of misuse when supplying these combination analgesic products."

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