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The Delights of a Chemical Smile


The inherent oddness in prescribing opiate based painkillers to people (and specifically parents) who have had a history of opiate addiction.


The title is drawn from Suede’s classic song, Animal Nitrate, which is probably the poppiest song that appears on the face of it to be about abuse  (Suzanne Vega’s “My name is Luka” being the only real competition I can think of right now)

The issue of opiate based painkillers has been on my mind for a while now; there are a raft of them, and those working within child protection will have become pretty familiar with them over the last five years. DF118 being the name that comes up most frequently (dihydrocodeine).  More and more often I am seeing this serious painkiller being prescribed to adults who have had a substantial history of opiate addiction, which would be well documented in their medical records.  Unlike, say, diclofenac (most commonly known by the brand-name Voltarol) which does not produce any opiate-based sensations, these prescribed medications do induce some of the pleasurable sensations (though on a much lesser level if taken at the correct dosage). If you have had to take them for genuine conditions, you may recall the fluffy sensation rather like being cuddled by a particularly friendly cloud.

I am tending to encounter it (a LOT) with parents, who have become clean for a time from heroin, and have then fallen back into heroin use. When one looks at the test results, or medical records, or very often their own statements, a prescription of dihydrocodeine for back pain, leg pain etc, preceded the relapse into heroin use. Of course, correlation is not causation, but invariably the parent who has relapsed into heroin use then has the twin difficulty of having to detox from heroin AND wean themselves off the prescribed opiate-based medication.  Frankly, at present, a parent who is a heroin user who DOESN’T also have terrible back pain or leg pain leading to the need for such a prescription is a rarity.

I do understand chronic and awful pain, I had a very good friend who was very young but had dreadful problems with her hips leading to the need for replacement hips in her thirties, and I am sure that medication like dihydrocodeine absolutely has its place for dealing with pain management at that high end of the spectrum. But I do wonder how much thought is being given to a history of opiate misuse/addiction being a contra-indicator for prescribing this sort of medication.  It isn’t doing these people, these parents, any favours, to have a readily available source of opiates.

About suesspiciousminds

Law geek, local authority care hack, fascinated by words and quirky information; deeply committed to cheesecake and beer.

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