Chronic pain: Expert discusses 'conflict' with using painkillers
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Painkillers come in many different forms and some provide help when others fail to work. Codeine falls into this category. Codeine is a painkiller that is part of a group of medicines called opiates. It’s used to treat pain, for example, after an operation or an injury.
Codeine is a popular choice for many Britons but evidence suggests it can prove harmful to certain people.
That’s the conclusion of a study published in the journal Digestive Diseases and Sciences.
Codeine is “suspected to cause acute pancreatitis in patients with a history of cholecystectomy,” wrote researchers in the study.
According to the NHS, acute pancreatitis is a condition where the pancreas becomes “inflamed (swollen) over a short period of time”.
The health body continues: “Most people with acute pancreatitis start to feel better within about a week and have no further problems. But some people with severe acute pancreatitis can go on to develop serious complications.”
Researchers sought to assess the association between codeine use and acute pancreatitis in patients with a previous cholecystectomy.
Cholecystectomy, also known as gallbladder removal surgery is a very common procedure. It is usually carried out if you have painful gallstones.
The researchers conducted a retrospective nested case–control study using the 2005–2015 MarketScan® Commercial Claims and Encounters Database.
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A matched nested case-control design provides an efficient way to investigate causal relationships using untapped data from prospective cohort studies and randomised controlled trials.
The cohort included patients aged 18–64.
Use of codeine was also compared with the use of non-steroidal anti-inflammatory drugs (NSAIDs).
Examples of NSAIDs include ibuprofen and aspirin
What did the researchers find out?
Of the 664,083 patients included in the cohort, 1,707 patients were hospitalised for acute pancreatitis and were matched to 17,063 controls.
Compared with non-use of codeine, use of codeine was associated with an increased risk of acute pancreatitis, particularly elevated in the first 15 days of codeine use.
Compared with use of NSAIDs, use of codeine was also associated with an increased risk of acute pancreatitis.
“Codeine is associated with an increased risk of acute pancreatitis in patients who have previously undergone cholecystectomy; greater clinician awareness of this association is needed,” the researchers concluded.
Codeine – everything you need to know
Codeine alone isn’t available over the counter.
It is only available in combination with paracetamol, aspirin or ibuprofen, and only at its lowest dose.
According to Bupa, co-codamol contains a mixture of codeine (8mg) and paracetamol (500mg) and you can take one to two capsules every four to six hours.
“Take no more than eight capsules in 24 hours. And make sure you account for any other single ingredient versions of painkillers you’re taking at the same time,” advises the health body.
“Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.”
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