Many people become dependent on a medicine that started with a doctor or a pharmacy, for pain, sleep or anxiety. If you now find yourself taking more than you meant to, or buying it yourself, you are not alone and you are welcome here.
What this covers
Medicines that can lead to dependence include painkillers such as codeine (found in co-codamol) and tramadol, sleeping tablets called Z-drugs such as zopiclone and zolpidem, benzodiazepines, and pregabalin and gabapentin. Dependence can start with a legitimate prescription, and it says nothing about your character. Benzodiazepines, pregabalin and gabapentin, and other opioids have their own pages: benzodiazepines, pregabalin and gabapentin and opioids and heroin.
Signs use may be becoming a problem
- Taking more, or for longer, than you were prescribed or the packet says
- Needing more to get the same effect
- Feeling anxious, restless or unable to sleep when you have not taken it
- Running out early, or buying more yourself
- Using it for stress or low mood rather than what it was prescribed for
Risks and safety: read this
- Alcohol, opioids, benzodiazepines, and pregabalin and gabapentin can all slow your breathing, so mixing any of them with these medicines is risky. See polydrug use. The NHS says not to drink alcohol with zopiclone, because it can cause breathing problems and make it very difficult to wake up.
- Some people carry on after a prescription ends by buying these medicines online or from other sources. The MHRA warns that illegal medicines sold without a prescription can contain harmful substances or the wrong dose, so you cannot be sure what is in them.
- If someone cannot be woken, or is struggling to breathe, call 999.
Codeine
Codeine is an opioid painkiller, and it is possible to become addicted to it. Co-codamol and similar products can be bought at a pharmacy without a prescription, but the NHS says pharmacy co-codamol should not be taken for more than three days. Codeine is a Class B drug.
Tramadol
Tramadol is a prescription opioid painkiller, and it is possible to become addicted to it. FRANK lists it as Class C. If you have taken it for more than a few weeks, the NHS says not to stop without speaking to your doctor first, because withdrawal can bring agitation, shaking, sweating, sleep problems and panic attacks.
Z-drugs: zopiclone and zolpidem
These are sleeping tablets. The NHS says zopiclone is usually not prescribed for more than four weeks, and zolpidem for two days to four weeks. You can become dependent on both, and zopiclone can lose its effect as your body gets used to it. Stopping suddenly can cause withdrawal symptoms such as anxiety, agitation, restlessness and a return of insomnia, so please speak to your doctor about coming off them gradually.
Support you can get alongside therapy
Therapy sits alongside medical care, not instead of it. How to get treatment without going through your GP, and where to find helplines.
What therapy can offer
- Understanding what the medicine does for you (pain relief, sleep, calm) and what else could help
- Practical strategies for the first weeks of reducing, alongside your prescriber
- Support with sleep, anxiety and pain that does not rely on the medicine
Confidentiality
Worried about your job or your driving licence? What I report, and what stays between us.
If it is someone you love
It can be hard to watch someone rely on a medicine they were given to help. Support for families and loved ones.
Short answers to common questions
Can I just stop taking it?
Please do not stop suddenly if you have been taking it for more than a few weeks. The NHS advises speaking to your doctor first for tramadol, co-codamol and zolpidem, because they reduce the dose gradually.
I buy it myself now. Can I still come?
Yes. I am not a medical service and cannot prescribe, so please involve a doctor or a drug treatment service for the medical side. Therapy works alongside that.
Is this the same as taking too much of something I was prescribed?
It can start that way. Therapy can help whichever way it began.
Can you get addicted to co-codamol?
Yes, it is possible. The NHS says you can become addicted to the codeine in co-codamol, though you are unlikely to if you follow your doctor’s advice on how long to take it. It lists finding it hard to stop, or feeling you need to take it more often than necessary, as signs. Long-term use can also bring tolerance, so you need more for the same pain relief.
Is it dangerous to take co-codamol with other paracetamol?
It can be. The NHS says taking too much co-codamol can be very dangerous because the paracetamol in it can cause liver damage, and that each tablet strength contains the same 500mg of paracetamol as a standard paracetamol tablet. If you take more than recommended and have trouble breathing, call 999 or go to A&E. If you feel well, the NHS says to contact 111 right away.
Can I drive on codeine, tramadol or zopiclone?
The NHS says not to drive, ride a bike or use machinery for 12 hours after zopiclone. For tramadol and co-codamol, it says not to drive if they make you sleepy, and not to drive if you are in any doubt. GOV.UK says it is an offence to drive if a legal drug impairs you. The NHS adds that police can ask for a saliva sample even if your driving seems unaffected.
How long does it take to come off codeine?
It depends on the person, and your doctor decides the timeline. The NHS says that after long-term use, the dose is typically reduced over several weeks or months, because your body can become used to codeine. It says not to stop codeine suddenly, and not to stop co-codamol without speaking to your doctor first if you have taken it for more than a few weeks.
How can I sleep without sleeping tablets?
The NHS says you may be offered cognitive behavioural therapy (CBT) for insomnia, face to face or as an online programme, which aims to change the thoughts and habits that keep you awake. It says sleeping pills are only prescribed for a few days or weeks at most, and that you can become dependent on them. I can help with the worry and routines around sleep, alongside your doctor.