Before I was receiving proper care, advice and treatment for my migraines, I managed them as best I could with what was available to me. And what was available to me was codeine.
My drug of choice was Nurofen Plus, which contains ibuprofen 200mg and codeine 12.8mg per tablet. A dose of 2 tablets therefore equated to 400mg iburofen and just over 15mg codeine.
This drug was passed on to me by my family and basically every well meaning pharmacist I ever spoke to. Mum has used codeine for years and was never given decent advice by her doctor. In my youth codeine had actually worked for me when my migraines where sporadic…they work really well and with limited consequence for most people who get a bad headache who are not chronic sufferers. It was only when they became more frequent in my early twenties that I came into trouble. The pharmacists should have known better but to be honest, I’m an intelligent, well dressed woman who can project an aura of “I know what I’m doing” to convince them to give me what I want. And when I was desperate, what I wanted was codeine, not discussions about long term solutions. To be fair it probably helped that I was often pale, clutching my head and looking like I might vomit when I purchased them so the pharmacist seemed happy to give what I asked. These were genuine migraine symptoms. But are they also medication overuse or withdrawal symptoms? Certainly.
Over a two-three year period I twice got myself into a situation where I ran out of my 90 tablet box after only one month. That was more than one dose a day. In fact it equated to one dose one day, two the next, for a whole month. I did not need a prescription to purchase this amount, just a photo ID, and my level of usage never prompted a pharmacist to decline to provide it to me. The primary side affect people warned me of at this time was stomach issues from too much ibuprofen, but in hindsight the bigger issue was the affects of the codeine, particularly overuse headaches. Essentially if you take too much codeine you get headaches from it (TMI, but I found this was worsened by the constipation side affect of codeine as well). What this means is that codeine is actually completely useless for chronic headache or migraine conditions. After the first few doses it is giving you a headache as opposed to resolving it, but what do you do when the overuse headache comes? Take another dose of course. And so the cycle continues.
I knew none of this of course. Neither did my Mum. And when your migraines are severe you don’t have much sense or ability to find long term solutions. That’s what the medical professionals are meant to do for you right?
This was at a time in my life where I had just moved out on my own, was working long days, traveling hours in commute, had no routine, no exercise, no healthy eating and no regular general health practitioner as I had moved to the big city and was reluctant to hunt for one. In short, I was a mess.
So at least twice I found myself on my last tablets and acutely aware of how recently I had bought them. And who knows how many times it happened and I didn’t register the rate of use. So at least twice I consciously weaned myself off the codeine. I would rely on plain Advil (ibuprofen gel tabs) and other remedies such as heat packs, massages and sleep. Codeine would get shelved for emergencies. But it was still several years before I finally found a doctor, and the right state of mind, to get treatment that would actually be meaningful. This treatment now involves migraine management, not pain management, and there is a huge difference.
Nowadays I only recently bought a codeine/paracetamol mix when I hurt my back and it was the first time I purchased it in a very long time. Prior to that I had only used it once in Codral Cold & Flu tablets last year and in 2013 for recovery from ovarian surgery. In other words I only use it for other body pain and never, ever for pain in my head.
Many people I know or have known use codeine for migraines. Pretty much very person I know who suffers chronic migraine has been addicted to it at least once. If you have a short term tension headache or suffer a migraine very rarely, it may be a very tidy solution. It kills the pain, and, depending on your tolerance for it, may knock you out for a while as your body sleeps off the migraine. But for anyone who suffers from regular migraine, particularly once a month or more, there are other, better options. See a doctor!