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Suggest Treatment For Addiction To Codeine Cough Syrup
Question: I am asking for my friend. He is codeine cough syrup addict. He takes every day around 1-2 bottles,4-5 on weekends. What exactly he uses and how much I don't know clearly. He is working in government job. My query is how can he seek treatment or psychological counselling, convincing etc to get rid of his habits without taking a long break or quitting his job. He is willing to try help but he says he won't compromise govt. job or risk creating medical records on his name for his job security.
He says that there is some psychological compulsion that he keeps going back to his habits. He says that short stress,problems of life which he always can't find the right people with whom venting out would help or every time he has a problem, he can't share everytime with such a helpful other person.....makes him take codeine as it destresses,calms his heartbeat and stops his thinking. He says he feels he won't be able to ever give up his habits. He has been to rehab 2 years ago once for around 3-4 months but he presently is back to his habits and says he is only on codeine syrups but I am not sure what all he uses. He is a chain smoker too. This addiction is going since past 9 years.
KINDLY GUIDE on what kind of treatment options are available(outpatient/inpatient/phsychological counselling etc.).....because he always says he can't seek treatment by taking leave from job. He fears going to doctor/seeking treatment also openly as it might cost him his government job. I am concerned about my friend. Kindly advise how to execute 'getting him help/treatment'. He says he only uses codeine now and cigarettes. Before rehab he did use marijuana,heroine,opiates etc. He says having cash with him makes it easier for him to buy codeine syrups from stores using prescriptions. How can we cut him from accessing money as he earns himself already. He says that he doesn't get the right kind of person to share his thoughts and who would understand him properly.He is very sensitive and a perfectionist. He says he has failed so many times on quitting his habits that he feels he will never be able to get rid if these habits ever. Please help. I don't know how to start getting him help as he always gives his job excuse but he has expressed he wants to get rid of these habits.
He also takes cigarettes once every 2-3 hours as he says cigarettes make him work faster, give him energy, make him feel more alert. He also has borderline personality disorder.
He says that there is some psychological compulsion that he keeps going back to his habits. He says that short stress,problems of life which he always can't find the right people with whom venting out would help or every time he has a problem, he can't share everytime with such a helpful other person.....makes him take codeine as it destresses,calms his heartbeat and stops his thinking. He says he feels he won't be able to ever give up his habits. He has been to rehab 2 years ago once for around 3-4 months but he presently is back to his habits and says he is only on codeine syrups but I am not sure what all he uses. He is a chain smoker too. This addiction is going since past 9 years.
KINDLY GUIDE on what kind of treatment options are available(outpatient/inpatient/phsychological counselling etc.).....because he always says he can't seek treatment by taking leave from job. He fears going to doctor/seeking treatment also openly as it might cost him his government job. I am concerned about my friend. Kindly advise how to execute 'getting him help/treatment'. He says he only uses codeine now and cigarettes. Before rehab he did use marijuana,heroine,opiates etc. He says having cash with him makes it easier for him to buy codeine syrups from stores using prescriptions. How can we cut him from accessing money as he earns himself already. He says that he doesn't get the right kind of person to share his thoughts and who would understand him properly.He is very sensitive and a perfectionist. He says he has failed so many times on quitting his habits that he feels he will never be able to get rid if these habits ever. Please help. I don't know how to start getting him help as he always gives his job excuse but he has expressed he wants to get rid of these habits.
He also takes cigarettes once every 2-3 hours as he says cigarettes make him work faster, give him energy, make him feel more alert. He also has borderline personality disorder.
Brief Answer:
He can get rid of from all bad habits,psychiatrist to be consulted
Detailed Answer:
Hello,
Thanks for writing to us.
I appreciate your concern for your friend.
You have narrated his history very well.
His habit of taking codeine was started in some stressful situation likely.Codeine is an opioid. After long use of codeine it leads to tolerance and physical dependence. After stopping codeine cold turkey it can cause severe withdrawal.Due to these withdrawal symptoms person cant leave it.In this situation deaddiction with medicines like buprenorphine, clonidine, pain killers and benzodiazepines is needed.Only counseling would not help.
At present he is in need of four types of treatment.
-Deaddiction from codeine
-Deaddiction from Cigarettes
-Treatment of stress or any other psychological condition(likely depression) which had compelled him to take such substances
-Borderline personality disorder(if diagnosis is confirmed)
The best person to consult for his problems is psychiatrist. By profession psychiatrist is a deaddiction specialist as well as counselor for such problem.Psychiatrist can motivate him for deaddiction for both codeine and cigarettes. Diagnosis of his psychological problem is also done by psychiatrist through detail history and mental status examination.
First step should be deaddiction from codeine.After that treatment of underlying psychological problem as well prevention of relapse of codeine use.And then deaddiction from smoking.
If he can narrate his situation to psychiatrist about government job and not in situation to take leave , he can be treated on OPD basis also. For that he may need to visit doctor everyday for 2-3 days to change dose of medicines according to withdrawal features and then every second day and then every third day so on.If withdrawal is severe, initial 2-3 days indoor treatment may be needed. I think psychiatrist can treat him with full confidentiality without disclosing any one.This will not cause any effect on his job.
Diagnosis of borderline personality disorder is done by psychiatrist after detail evaluation. And if he is diagnosed by psychiatrist, please let me know details for the same with detail symptoms if you are aware.It is difficult to treat. It requires multiple medicines, psychotherapy and social support.(Considering his government job I don't think that he has borderline personality disorder as person with this problem rarely can sustain his work without any break)
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
He can get rid of from all bad habits,psychiatrist to be consulted
Detailed Answer:
Hello,
Thanks for writing to us.
I appreciate your concern for your friend.
You have narrated his history very well.
His habit of taking codeine was started in some stressful situation likely.Codeine is an opioid. After long use of codeine it leads to tolerance and physical dependence. After stopping codeine cold turkey it can cause severe withdrawal.Due to these withdrawal symptoms person cant leave it.In this situation deaddiction with medicines like buprenorphine, clonidine, pain killers and benzodiazepines is needed.Only counseling would not help.
At present he is in need of four types of treatment.
-Deaddiction from codeine
-Deaddiction from Cigarettes
-Treatment of stress or any other psychological condition(likely depression) which had compelled him to take such substances
-Borderline personality disorder(if diagnosis is confirmed)
The best person to consult for his problems is psychiatrist. By profession psychiatrist is a deaddiction specialist as well as counselor for such problem.Psychiatrist can motivate him for deaddiction for both codeine and cigarettes. Diagnosis of his psychological problem is also done by psychiatrist through detail history and mental status examination.
First step should be deaddiction from codeine.After that treatment of underlying psychological problem as well prevention of relapse of codeine use.And then deaddiction from smoking.
If he can narrate his situation to psychiatrist about government job and not in situation to take leave , he can be treated on OPD basis also. For that he may need to visit doctor everyday for 2-3 days to change dose of medicines according to withdrawal features and then every second day and then every third day so on.If withdrawal is severe, initial 2-3 days indoor treatment may be needed. I think psychiatrist can treat him with full confidentiality without disclosing any one.This will not cause any effect on his job.
Diagnosis of borderline personality disorder is done by psychiatrist after detail evaluation. And if he is diagnosed by psychiatrist, please let me know details for the same with detail symptoms if you are aware.It is difficult to treat. It requires multiple medicines, psychotherapy and social support.(Considering his government job I don't think that he has borderline personality disorder as person with this problem rarely can sustain his work without any break)
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Raju A.T
I am honestly very happy,relieved from your advise and guidance on the flow of course action to be taken in this matter. My friend had informed me that either it is bipolar disorder or borderline personality disorder that was detected by doctors during his rehab stay. He doesn't remember exactly which one is it and his file is in home while he is working in a different city so I am unable to provide the exact detail now. However, You may lend your kind advise incase if it's bipolar disorder(he is suffering from) as you suggested about borderline personality disorder.
I forgot to mention a very important thing is that before his rehab 2 years ago, he had suffered from 2/3 seizures. Presently as far as i know since 2013, he gets one seizure usually in every 3/4 months (as told by him, i don't know the exact truth). He says its because of codeine overdose of his intake.
I have understood the course of action about how to proceed to get him help. I just wanted to ask that how serious could be his condition as he has been with these habits since 9 years and his quite frequent seizures since 2013 and his present daily intake of codeine syrup. How badly does this situation impact his lifespan or other major risks that he could be become exposed to?
He is pretty much active in his job. He does sometimes miss office(full-day) when he overdoses on codeine. I don't think he takes break inbetween his office hours so i understand that it has to be correctly detected if he is suffering from bipolar disorder or borderline personality. Another query is can he get married in near future while he undergoes this treatment process. Is there any compulsive rule that unless drug abusers are clean, only then they can be suitable partners?
He has been staying alone since his job and loneliness might be more dangerous when it comes to his habits.
I forgot to mention a very important thing is that before his rehab 2 years ago, he had suffered from 2/3 seizures. Presently as far as i know since 2013, he gets one seizure usually in every 3/4 months (as told by him, i don't know the exact truth). He says its because of codeine overdose of his intake.
I have understood the course of action about how to proceed to get him help. I just wanted to ask that how serious could be his condition as he has been with these habits since 9 years and his quite frequent seizures since 2013 and his present daily intake of codeine syrup. How badly does this situation impact his lifespan or other major risks that he could be become exposed to?
He is pretty much active in his job. He does sometimes miss office(full-day) when he overdoses on codeine. I don't think he takes break inbetween his office hours so i understand that it has to be correctly detected if he is suffering from bipolar disorder or borderline personality. Another query is can he get married in near future while he undergoes this treatment process. Is there any compulsive rule that unless drug abusers are clean, only then they can be suitable partners?
He has been staying alone since his job and loneliness might be more dangerous when it comes to his habits.
Brief Answer:
Seizure is mostly due to codeine overdose,long term treatment required
Detailed Answer:
Hi,
Thanks for follow up and more useful information.Sorry for delayed response from my side.
Bipolar disorder has good prognosis than borderline personality disorder.In bipolar disorder chances of untreated depression is more which may lead to such type of substance use to relieve stress and depression.Again for confirmation of diagnosis detail history, evaluation and mental status examination are required.In bipolar disorder relapse can be prevented with taking regular mood stabilizer medicines.
Opioid overdose can cause seizure. To check he is suffering from epilepsy or not, history of such episodes, relation with codeine use and electroencephalogram(EEG) are required. If needed MRI brain can be done.
If seizures are due to codeine use, deaddiction from the same is the treatment.
Course of action is consultation of psychiatrist and regular follow up. This treatment may last up to few months or may be years. As time passes interval between follow up will increased. Diagnosis of psychiatric problem, deaddiction, EEG, counseling all will be done by a psychiatrist. Constant touch with one psychiatrist will be really helpful.After detoxification and deaddiction, his psychiatric problem needs to be treated. And then main target should be prevention of relapse of substance as well as psychiatric problem. This can occur with help of counseling and medicines through regular follow up of psychiatrist.
Yes excessive intake of codeine overall is affecting his health. We can not judge effect on lifespan at present but his physical,mental and social health is worsening and cause many serious complications(increase intake, injury during seizures, decrease capacity to work,death wishes) in life if this habit continues.
He can go for marriage. But before that he should be treated sufficiently in the manner that he can carry out responsibility of marriage. In my opinion whenever he proceeds for marriage , his life partner should be aware about his past and accept the reality that he needs regular follow up to prevent relapse in future and she may have to accompany him if by chance relapse occurs.More counseling regarding marriage(pros and cons) can be done by treating psychiatrist. Even if any girl becomes ready ,she should also meet his treating psychiatrist and understand the reality.
Loneliness can affect his mental status. If some family member is there to understand and care him, he can recover fast.
Hope this answer will be helpful, if more queries I will be glad to answer.
Regards,
Dr.Chintan Solanki.
Seizure is mostly due to codeine overdose,long term treatment required
Detailed Answer:
Hi,
Thanks for follow up and more useful information.Sorry for delayed response from my side.
Bipolar disorder has good prognosis than borderline personality disorder.In bipolar disorder chances of untreated depression is more which may lead to such type of substance use to relieve stress and depression.Again for confirmation of diagnosis detail history, evaluation and mental status examination are required.In bipolar disorder relapse can be prevented with taking regular mood stabilizer medicines.
Opioid overdose can cause seizure. To check he is suffering from epilepsy or not, history of such episodes, relation with codeine use and electroencephalogram(EEG) are required. If needed MRI brain can be done.
If seizures are due to codeine use, deaddiction from the same is the treatment.
Course of action is consultation of psychiatrist and regular follow up. This treatment may last up to few months or may be years. As time passes interval between follow up will increased. Diagnosis of psychiatric problem, deaddiction, EEG, counseling all will be done by a psychiatrist. Constant touch with one psychiatrist will be really helpful.After detoxification and deaddiction, his psychiatric problem needs to be treated. And then main target should be prevention of relapse of substance as well as psychiatric problem. This can occur with help of counseling and medicines through regular follow up of psychiatrist.
Yes excessive intake of codeine overall is affecting his health. We can not judge effect on lifespan at present but his physical,mental and social health is worsening and cause many serious complications(increase intake, injury during seizures, decrease capacity to work,death wishes) in life if this habit continues.
He can go for marriage. But before that he should be treated sufficiently in the manner that he can carry out responsibility of marriage. In my opinion whenever he proceeds for marriage , his life partner should be aware about his past and accept the reality that he needs regular follow up to prevent relapse in future and she may have to accompany him if by chance relapse occurs.More counseling regarding marriage(pros and cons) can be done by treating psychiatrist. Even if any girl becomes ready ,she should also meet his treating psychiatrist and understand the reality.
Loneliness can affect his mental status. If some family member is there to understand and care him, he can recover fast.
Hope this answer will be helpful, if more queries I will be glad to answer.
Regards,
Dr.Chintan Solanki.
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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