Over-the-counter (OTC) medications are medications that you can buy from a pharmacist without a prescription. Patients often complain that OTC drugs should not be restricted during the Methadone Maintenance Treatment program because they are available without a prescription. I will discuss the reasons you should not use OTCs drugs that contain Codeine.
Codeine is a common ingredient in OTC drugs. Please check the ingredients on your OTC medication to see if Codeine is, in fact, present. Examples of OTC medications that contain Codeine include Tylenol 1, some cough syrups, Robaxacet, as well as various allergy and cold remedies.
Even a small amount of Codeine can cause your urine drug test to become positive for Morphine. This is because Codeine is metabolized by the liver into Morphine. In fact, Codeine itself has no pain relieving action on the body. This is why people do not inject Codeine. Codeine must be eaten, and then it will pass through the liver, get metabolized into Morphine. Only then can it give it’s pain relieving qualities. So, in the end, if you take even a small amount of Codeine, it looks like you are using Heroin, or other similar opiates, on the urine drug test.
For this reason, it is important that you avoid all Codeine containing products while in treatment.
Pain is a very useful thing. It lets you know that you have caused damage to your body. It is not always to your benefit to remove all, or sometimes even any, of the pain. The pain can help you avoid certain activities that are causing your body harm, and avoid making your condition worse.
Some patients say that “the pain was so bad, regular Tylenol and Advil did not help. I had to take a T3!” My feeling is that if the pain is strong enough that you feel the need to take something stronger than regular Tylenol or Advil, then you really need a firm diagnosis, and medical supervision, from a medical professional. In this kind of situation, you should visit the emergency department, Walk-in Clinic, or your physician. Any opiate medication that you take will simply mask the pain, causing delayed diagnosis and appropriate treatment.
For example, you may have back pain from working. If you take Codeine, the pain will be reduced, and this will allow you to work more. The problem is that the source of the pain has not been treated. So, continuing to do what caused the pain in the first place will make the pain, and damage that the pain indicates, worse. The result will likely be more pain. In general, it is important to avoid using Codeine unless advised by a doctor.
Tylenol 1, 2, or 3, contain small amounts of Codeine. If your Methadone dose is any higher than a minimal dose, then the Codeine in these formulations are likely not giving you much pain relief at all. They are probably only making your urine drug test show up positive for Morphine. The pain control you are experiencing is more than likely due to the acetaminophen, or regular Tylenol, that is in the formulation. Try using Tylenol regular, or extra strength, and see if that alone will help your pain as much as the Tylenol with Codeine. Please be advised that Tylenol does have side effects and complications of its own. These are mostly related to the liver. Please check with your doctor to make sure it is safe for you to take Tylenol.
Another choice would be to use Advil, or other anti-inflammatories. The benefit of these anti-inflammatories is that they will decrease the swelling and inflammation that is causing the pain. In many cases, the anti-inflammatory will leave you with a little bit of pain. This residual pain is useful to let you know what you shouldn’t to be doing. Basically, if it hurts, don’t do it. Please check with your doctor before using these, as there are some conditions that make using over-the-counter anti-inflammatories dangerous. These conditions include ulcers, hiatal hernias, or other conditions that are sensitive to anti-inflammatories.
If you are using eight or more Advil or Tylenols per day, then you should see a medical professional. Both of these medications have side effects, so prolonged regular use can result in damage to your body. Sometimes this damage can be permanent and potentially life-threatening.