Hooked on what the doctor prescribed
Nobody plans to get hooked on their headache tablets.
That’s what makes this one so hard to talk about. With alcohol or drugs, at least people expect that it could become a problem. But medication? Medication is supposed to help. A doctor gave it to you. Or a pharmacist handed it over the counter with a smile. How can something like that become the thing you’re quietly terrified of running out of?
If you’re reading this with a knot in your stomach, I want you to know something first: this is far more common than you think, and it is absolutely nothing to be ashamed of.
It almost always starts with a real reason
Nobody wakes up and decides to become dependent on codeine. It starts with a back injury that won’t settle. A rough patch of anxiety after a divorce. Months of broken sleep with a newborn, or a business that’s keeping you up at night. Migraines. Grief.
The medication works. That’s the thing. It takes the pain away, or the panic, or the racing thoughts. You feel like yourself again.
And then, slowly, something shifts. One tablet becomes two. You start taking it before the pain arrives, just in case. You notice you’re reaching for it on a stressful afternoon even though your back is fine. You’re not taking it for the symptom anymore. You’re taking it for the feeling.
And somewhere in the back of your mind, a small worried voice starts asking: what happens if I run out?
South Africa has a codeine habit
You might be surprised by this. In South Africa, many codeine combination painkillers can be bought over the counter at a pharmacy, without a prescription.
A study across 31 countries found that South Africa accounted for about a third of all over-the-counter codeine sales between 2013 and 2019. More than any other country in the study. Not by a little, either.
There are rules meant to keep this in check. These products are classed as Schedule 2 medicines, which means:
- a maximum of 10mg of codeine per tablet
- a maximum of 80mg a day
- a pack big enough for no more than five days
- the pharmacy is supposed to record your name, ID number and address
But here’s the reality, and maybe you know it already. It’s very easy to visit three different pharmacies in one afternoon. Nobody connects the dots. Many people do exactly this, telling themselves a different story at each counter.
If that’s you, please hear me: I’m not judging you. I’m telling you this because you’re not the only one, and there’s a way out.
The medicines we see most often
These are the names people bring to us again and again:
- Codeine painkillers: Myprodol, Mybulen, Adco-Dol, Betapyn, Syndol
- Tramadol: Tramazac, Tramal, Dolorol Forte
- Anxiety medication (benzodiazepines): Xanor, Rivotril, Valium or Pax, Ativan
- Sleeping tablets: Stilnox
- Stimulants: Ritalin, Concerta, Vyvanse
- Nerve-pain medication: Lyrica, gabapentin
And mixing any of these with alcohol makes everything more dangerous, including the risk of overdose. If you’re doing that, please speak to someone soon.
Warning signs to be honest about
- You take more than prescribed, or more often.
- You run out before your script is due, and have a story ready for the doctor.
- You see more than one doctor, or use more than one pharmacy.
- You buy over-the-counter codeine in bulk, or “stock up.”
- You feel like you can’t get through the day without it.
- You use it for your mood, stress or sleep, rather than the original reason.
- You feel a flash of panic when you realise the box is nearly empty.
Please, please don’t stop on your own
This is the most important part of this article, so I’m going to be very direct.
Do not stop suddenly.
Coming off benzodiazepines, sleeping tablets or opioids too quickly can cause severe withdrawal. With benzodiazepines in particular, it can be dangerous. Your body has adjusted to having the medication there, and pulling it away overnight is a shock it may not handle safely.
The right way is with a doctor, usually with a slow taper over weeks or months. We’ll help you find a doctor who understands this. While they look after the medical side, we work with you on everything else: the emotions, the habits, the triggers, the reasons you started reaching for it in the first place.
You don’t have to choose between suffering through withdrawal alone and staying stuck. There’s a middle road, and it’s much safer.
“But I genuinely need it.”
Maybe you do. And that’s okay.
Recovery doesn’t mean refusing all medication for the rest of your life. If you have chronic pain, a real anxiety disorder, or ADHD, medication can be an important part of living well.
What recovery means is honesty. Taking it exactly as prescribed. Making sure your doctor knows your full history, including the parts you’ve been keeping quiet. And building other ways to cope, so that the tablet isn’t the only tool in your toolbox.
When a pill is your only way of managing stress, pain or sleep, it ends up holding all the power. When you’ve got other tools, like understanding your triggers, managing your thinking, real connection with people, it becomes what it was always supposed to be. Just medicine.
You started taking it to feel better. Let’s find a way for you to actually feel better.
Book an assessment or WhatsApp Steven on +27 76 402 7083. It’s confidential.
Sources: Bhekisisa – SA school children high on codeine cough syrup; Daily Maverick – Codeine regulation: a fine line between pain relief and addiction.
