Codeine and Tramadol; The Dangers of Abuse

Many of us are familiar with these drugs: codeine and tramadol and we must have heard tales of how they take pains and sorrows away magically to the extent that many people especially our youths can’t go a day without them but little do many know that if care is not taken, more harm will be caused than good.

Codeine just like tramadol belongs to a group of drugs called opiates or opioid analgesics. These group of drugs are naturally or synthetically derived from the narcotic component of the opium poppy. They are drugs naturally prescribed for the management of pains(e.g tramadol) and cough suppression(e.g. codeine). They also include drugs like morphine, pentazocine, dihydrocodeine, fentanyl etc. Aside from the analgesic and antitussive effect, they also produce a feeling of euphoria, drowsiness and sedation in users.

Feeling of euphoria or getting high like the majority know it, associated with the use of these two opiates is the major reason many have turned it into a daily medicine. People go to pharmacies under the guise of ‘’I need something for my very stubborn cough” and insist on getting a cough syrup containing codeine. Most times, you get to suspect an addiction from their reaction when you insist on getting a doctor’s prescription before dispensing the drug ( that’s actually for those not carrying a prescription, a significant percentage of abusers now carry prescriptions with them). Some go to the extent of stealing these drugs just to get the feeling of euphoria again.

But in all of these, the only thing many are aware of is the euphoria and nothing else, they never get to talk about the dangers attached to the abuse of these two drugs. This article is going to focus on the dangers associated with the abuse/addiction of this drugs and how these can be prevented and managed.

The Dangers

1. HYPOXIA

Tramadol and codeine just like other opiates are capable of causing respiratory depression ( slowed breathing ) which results in low level of oxygen supply to the brain which could, in turn, lead to coma or brain damage or even death (this is very common with overdose)

2. TOLERANCE

When these drugs are consumed for an extended period of time, it gets to a point where the initial dose doesn’t produce the desired effect again. At this stage, the consumer may have to increase the dose to get the desired effect and the cycle may continue and lead to grave consequences.

3. DEPENDENCE

A person is said to be dependent on opioids when he/she can’t feel normal without the drug. Abuse of opioids usually leads to dependence over a period of time and it could take a minimum of three months to recover.

4. ADDICTION

When people continue to look for any means to get the drug and use it despite the damage it is causing to their health, they are said to be addicted. This happens when they are not able to control their compulsive need for the drug. Addiction can lead to social withdrawal, violence and sometimes suicide. It could also lead to some social problems like financial problems as they don’t mind spending all their money to get the drugs, some end up selling their properties too.

An addict will have to go through therapy which could be drug therapy or psychotherapy or both before they can recover.

5. WITHDRAWAL

When people become addicted to opiates and suddenly stop, they experience withdrawal symptoms likes anxiety, nausea, vomiting or abdominal pain. While symptoms can be severe, they aren’t life-threatening.

Other dangers include depression, seizures, heart failure and immune suppression

PHYSICAL SYMPTOMS OF OPIOID ABUSE

• Noticeable euphoria
• Marked sedation
• Confusion
• Constricted pupil
• Slowed breathing
• Doctors shopping (getting prescriptions from different doctors)
• Social withdrawal
• Mood swings

PREVENTION AND CONTROL

1. Use only when prescribed and only for the specific dose and duration
2. Health professionals should also avoid prescribing them for the young ones except when there are no alternatives
3. Public awareness of the dangers of abuse of these drugs
4. Extensive physician and patient education regarding these medications and their associated risks for abuse
5. The development of prescription monitoring programs to detect physician or pharmacy shopping
6. The detection of inappropriate prescribing and medical errors
7. The use of physician-patient contracts concerning opioid treatment
8. Provisions for safe disposal of unused opioids
9. Referrals to pain and addiction specialists

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