What we hear less about is addiction to over-the-counter (OTC), aka non-prescription, drugs. Which, by the way, is rife in the UK and while it's impossible to know exactly how many people are affected, a 2015 survey by ITV's Tonight suggested it could be as many as 900,000 – and there's also reason to believe the problem is growing, with many young women suffering in silence.
Drug and alcohol charity Addaction told Refinery29 that while there are no specific figures relating to the number of young women addicted to OTC drugs, "young women might feel stigmatised and find it hard to seek help", according to Rachel Britton, the charity's lead clinical pharmacist. The number of people approaching the charity with OTC drug addiction is increasing and at the same time they say that prescriptions of certain pain medications are increasing, too.
The most common OTC drugs to be misused, and potentially cause dependency, are those containing the opiate codeine, a painkiller used to treat moderate pain, such as headaches or dental pain. In its purest form, codeine is only available on prescription but when mixed with aspirin, ibuprofen or paracetamol, it's available for anyone to buy over the counter, in Boots, any pharmacy or at your local supermarket. The guidelines around sales of codeine-based painkillers were tightened in 2009 to help combat overuse and misuse. Warnings about the importance of sticking to the recommended dosage and the drug's addictive properties were added to packs – the label for Nurofen Plus, for example, clearly states that codeine can "cause addiction if you take it continuously for more than three days".
Most people don't experience problems with OTC drugs and can stick to the recommended dosage of six to eight tablets a day for a maximum of three days. But others, after initially only using these drugs for pain relief, develop a psychological and/or physical dependency that leaves them unable to function without the drugs. "Some people are unable to stop taking the drug, even after their physical pain has gone away, because they enjoy the feeling and it can be an escape," says Britton. "It’s important people are made aware of how powerful codeine is – you don’t have to be taking the medication for very long before it can become a real problem."
'Addicted' is a strong word, but I guess there's no other word for it. I need to take these pills every night.
Codeine isn't the only problem. Medicines containing the decongestant pseudoephedrine, used to treat colds, sinus infections and allergies, along with many other commonly available drugs, are also causing issues in people's daily lives. Sarah, 30, suffers with chronic insomnia and depends on the antihistamine Phenergan (promethazine) to get through the day; the drug is commonly used to treat allergies and many doctors strongly advise against taking it for sleep.
"'Addicted' is a strong word, but I guess there's no other word for it," she told Refinery29. "I need to take these pills every night otherwise I don't function well. If I run out, I panic and it has a significant impact on my day." Pharmacists have warned her against taking the drug for sleep and have even withheld it after she's revealed her true motive for needing it. "Now, I just lie and say I've been bitten so need an antihistamine and they hand it over.
"When I don't have [my usual sleep medication, Zopiclone (zimovane)], I'll try anything to get to sleep. I've even called drug dealers to deliver Xanax or diazepam (Valium) when my insomnia is particularly bad. But someone told me Phenergan worked and you could buy it over the counter, so I started taking it about six months ago."
Her dependence regularly determines how she organises her day. "If I run out of Phenergan and I don't have Zopiclone, I start to panic. I'll frantically google late-night pharmacists and try and get there before they close – there aren't many late-night pharmacists – because I know I won't sleep that night if I don't have it and the next day becomes difficult because I'm exhausted."
I realised I was addicted when the pills were on my mind 24/7 and I couldn't go a day without them.
Thirty-one-year-old Chloe developed a three-year dependence on sleeping pills in her mid-20s after the sudden death of her father. She turned to overwork to "keep herself busy" after the loss and became unable to fall asleep naturally. Chloe was initially prescribed temazepam by her doctor, a powerful drug only used to treat insomnia in the short term (for up to four weeks) due to its addictive properties, but once this ended she became dependent on Boots' own-brand OTC sleeping pills, Sleepeaze, taking three per night – treble the recommended dose.
"I realised I was addicted when the pills were on my mind 24/7 and I couldn't go a day without them," she told Refinery29. She says she was constantly "spaced out, stupid and dozy" and lost two stone in weight as she was "too tired all the time" to eat. "Everything was an effort. They affected my heart and lowered my blood pressure so much I collapsed at work one night in the loos." Her relationships suffered, too, leaving her isolated for three years. "I hid my addiction from my family, which meant I wouldn’t see them, and colleagues and friends thought I was smoking weed so didn’t want much to do with me."
Author and journalist Cathryn Kemp, who founded the Painkiller Addiction Information Network after suffering with addiction to prescription drugs in her early 30s, believes addiction to OTC painkillers is accelerating among women. "It's becoming way more common in women aged 20-60," she told Refinery29. "When I was in rehab I was told that the biggest leap in patients addicted to their medication was among women."
Similarly, Jeff van Reenen, an addiction treatment programme manager at Priory Hospital Chelmsford, acknowledges that while addiction is a disease that knows no age, socioeconomic or gender barriers, "women may find it more difficult to engage in rehab treatment, due to family commitments or social stigma and repercussions in the community."
Sarah admits she needs to change her life, but realises it won't be easy to overcome her addiction. "I know I need help and I accept that, but I was on antidepressants with side-effects for six years, and I'd just had enough," she admits. "So I tried something else and there aren't any side-effects that I can see in my daily life right now, taking Phenergan. Maybe there will be one day, but I often struggle to get through the day, so I try not to think about the future."
If you are struggling with substance abuse, Addaction can offer support. It has services across the country and a webchat where you can speak to someone confidentially.
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