Soon to need a prescription for Nurofen/Solphadine/etc?

sesna

yogy wrote: »

These are 3 probable scenarios:

Scenario #1:

JoePublic (after looking around a bit lost looking):."Hi, do you not sell solpadeine here?"

Pharmacist: "We do, we just don't display it anymore"

JoeP: "Fair enough, give us a pack of of solpadeine please, 24, soluble"

Pharmacist: "You do realise these contain codeine and..."

JoeP: "Ya, ya, I know...max dose is 8 a day and all that"

Pharmacist: "Well I am obliged to inform you.."

JoeP: "I know ya, cheers, here ya go..

Pharmacist: "Thank you"..

Scenario #2

JoeP: "Hi, can I have a pack of nurofen plus please"

Pharmacist: "Do you mind me asking what is the problem?"

JoeP: "I have a wicked toothache, I was up all night"

Pharmacist: "What about taking some plain nurofen first off to see if that does it"

JoeP: "Nah, you're all right I'd prefer the plus"

Pharmacist: "Sorry but I think nurofen might be sufficent, you might be unnecessarily taking codeine"

JoeP: "So will you not sell me any of the plus?"

Pharmacist: "I'm afraid not!"

And off goes JoeP into the other pharmacy 2 doors down to get served his nurofen plus.

Scenario #3:

JoeP: "Hi, do you have any solpadeine?"

Assistant: "Hold on and I'll get the pharmacist
(comes over to Pharmacist in dispensary)..
."that man wants some solpadeine, can you talk to him?"

Pharmacist: "Look, it's lunchtime and I've got 5 Rx's to dispense including Mrs. Murphy who wants all her Amitriptyline 25mg split in half along with the other 27 items on her Rx, just give him a pack of solpadeine...Thanks"

If you ask me they should treat these products like cigarettes...
1) Don't sell to minors
2) Ban advertising of these products (inc. pharmacy windows)
3) Have big warnings like on fags saying: "WARNING, EXCESSIVE USE MAY LEAD TO ADDICTION"
(maybe even have a picture of a junkie madouvit on the box!! )

Sadly, each of those situations would be 100% compliant with the guidelines (keep out of sight, have a consultation which explains codeine addiction potential ) , which is why, in my opinion, they are nothing more than half-assed measure which will just serve to remove the choice from responsible users, while addicts will still get their hands on them no problem.

As I said, if there is evidence of a problem (the PSI carried out no proper studies in Ireland), then representations shoudl have been made to the Irish Medicines Board to put these products on prescription.

Just as an aside, I wonder if these guidelines will apply to Nicorette products also. My cousin has been chewing on nicorette gum for 2 years and is now clearly addicted to it. Or has the media not started a campaign against those products yet ?

Wibbs

sesna wrote: »

Just as an aside, I wonder if these guidelines will apply to Nicorette products also. My cousin has been chewing on nicorette gum for 2 years and is now clearly addicted to it. Or has the media not started a campaign against those products yet ?

Far better than smoking though. Like a million times better. Nicotine in of itself while a poison in larger doses is not the issue in smoking. It doesnt cause cancer, studies in animals have found no long term issues from taking it in the doses ex smokers on gum etc do and may actually have a protective effect on illnesses like parkinsons, IBS and ulcerative colitis. The latter is very rare in smokers. It also seems to have a similar if not better effect than many other drugs in reducing the symptoms of ADD in adults(and kids). Some people are very strongly addicted to nicotine. Even years on can fall off the wagon, so I'd rather they chewed the gum(or more recently use vapour nicotine inhalers) than get that fix from ciggies. The same ciggies I can use as a drug delivery system and buy in any newsagents.

Jesus some people would restrict every bloody thing.

sesna

Wibbs wrote: »

Far better than smoking though. Like a million times better. Nicotine in of itself while a poison in larger doses is not the issue in smoking. It doesnt cause cancer, studies in animals have found no long term issues from taking it in the doses ex smokers on gum etc do and may actually have a protective effect on illnesses like parkinsons, IBS and ulcerative colitis. The latter is very rare in smokers. It also seems to have a similar if not better effect than many other drugs in reducing the symptoms of ADD in adults(and kids). Some people are very strongly addicted to nicotine. Even years on can fall off the wagon, so I'd rather they chewed the gum(or more recently use vapour nicotine inhalers) than get that fix from ciggies. The same ciggies I can use as a drug delivery system and buy in any newsagents.

Jesus some people would restrict every bloody thing.

I agree but I am simply applying the same standards applied to Nicorette that will now relate to codeine products.

The licensing on Solpadeine etc is 3 days. For Nicorette is 12 weeks, yet people are using it for years. 12 weeks is more than sufficient to have broken psychological cues to smoking, and the physiological addiction will be gone long before then. So its pointless to carry on using it past 12 weeks, yet no-one is ever challenged when purchasing it. And more importantly, there does not seem to be any system, studies, or literature on how to wean people slowly off it. Seems the drug companies are more than happy to continue selling their product.

I cant think of many obvious adverse effects of long-term use of nicotine, but it does cause increase blood pressure, and may cause gastro-intestinal problems such as acid reflux etc or mouth ulcers etc. Obviously alcohol is another obvious drug which is commonly sold to drunk people and people suffering with alcoholism without any meaningful regulation or restriction. I chose Nicorette as thats sold from a pharmacy.

Also, I personally am not in favour of restricting every bloody thing, and would be the opposite actually calling for more stuff on prescription to be available without prescription such as oral contraceptives, cholesterol tablets, etc.

(Another small aside, I find it interesting that Nurofen plus is a max dose of 6 daily for three days. Thats 18 tablets, yet 24 are in the box :rolleyes:

Also, what does 3 days maximum use mean? Does that mean I can use it for 3 days, take a twelve hour break and use it again for 3 days indefinetely. Or should I take a two day break, before buying it again... )

Kurtosis

sesna wrote: »

Sadly, each of those situations would be 100% compliant with the guidelines (keep out of sight, have a consultation which explains codeine addiction potential ) , which is why, in my opinion, they are nothing more than half-assed measure which will just serve to remove the choice from responsible users, while addicts will still get their hands on them no problem.

This "half-assed" measure doesn't actually contain anything new. These guidelines are merely highlighting and interpreting laws that are already in place, so technically the things in this guidance should have been done all along (and some parts of the guidance for all non-prescription medicines).

As I said, if there is evidence of a problem (the PSI carried out no proper studies in Ireland), then representations shoudl have been made to the Irish Medicines Board to put these products on prescription.

I thought I had read somewhere that the IMB was undertaking an assessment into codeine-containing analgesic products, but I can't track it down at the moment, I may have just imagined it!

yogy

sesna wrote: »

12 weeks is more than sufficient to have broken psychological cues to smoking, and the physiological addiction will be gone long before then. So its pointless to carry on using it past 12 weeks, yet no-one is ever challenged when purchasing it.
)

"12 weeks is more than sufficient to have broken psychological cues to smoking, and the physiological addiction will be gone long before then."

Source to this claim please. Total bollix.

Whatever about kicking physical addiction after a certain period, there is no time limit on how long a person remains psychologically addicted; it is impossible to put a time frame on something like this.

At the end of the day, even if a person stays chewing nicorette gum for the rest of their life they are doing nowhere near the same level of damage to themselves (or others) than if they had continued to smoke.

To compare nicorette and codeine wrt to addiction just shows a complete lack of understanding of the issue of addiction and its treatment.

sesna

yogy wrote: »

"12 weeks is more than sufficient to have broken psychological cues to smoking, and the physiological addiction will be gone long before then."

Source to this claim please. Total bollix.

Whatever about kicking physical addiction after a certain period, there is no time limit on how long a person remains psychologically addicted; it is impossible to put a time frame on something like this.

At the end of the day, even if a person stays chewing nicorette gum for the rest of their life they are doing nowhere near the same level of damage to themselves (or others) than if they had continued to smoke.

To compare nicorette and codeine wrt to addiction just shows a complete lack of understanding of the issue of addiction and its treatment.

They're both addictions. Your argument is absolute bulls*hit. And, yes thank you, its so f*ucking obvious that smoking cigarettes is worse than chewing on nicorette.

Did I touch another raw nerve of a pharmacist whose hand is in the greasy till? Why do you think manufacturers recommend maximum 12 week use with step-down to lower doses after 4 and 8 weeks use. Actually the psychological cue breaking happens after around 8 weeks. Obviously people need to learn to experience situations such as going to the pub or holding a drink without having a box of nicorette chewing gum in their pockets, or a box of cigarettes. They certainly have no chance of overcoming nicotine addiction, physiological or pychological, when they continue to take the very drug they are trying to give up on a regular basis, whether it be from a cigarette or from a chewing gum.

I did say, several times, that I cannot see the obvious dangers of long-term nicotine use, and was merely comparing the two as both are addictions. Also why is there no system in place to control people who have given up cigarettes for years, but yet are still using these products unnecessarily and frequently.

As an aside I do find it amusing that one is legally not allowed to buy more than two boxes of paracetamol from a pharmacy, yet a drug addict can go in and legally get a few hundred ml of methadone, or a new clean needle to inject himself with heroin.

yogy

sesna wrote: »

They're both addictions. Your argument is absolute bulls*hit.

What arguement? I simply asked for a source.

sesna wrote: »

why is there no system in place to control people who have given up cigarettes for years and are still using these products unnecessarily and using them frequently.

What kind of system would you recommend and how would it be funded?

sesna wrote: »

Also can you highlight to me these sinister long-term dangers of taking codeine-containing products, that made them so much worse than nicotine,

Nurofen Plus-Stomach ulceration

Solpadeine-Liver failure

both of which, if undiagnosed can prove fatal.

Now for a very quick lesson for you to try and understand the difference:

Nicotine is a replacement therapy for smoking, just as methadone is for heroin.

You do not get any hit/kick from Nicotine replacement products just as you don't from methadone, they simply help to deal with the cravings/withdrawl.

Codeine acts on opioid receptors, people get a kick out of this...some people will inevitably enjoy this kick too much and become addicted to said product.

Now do you understand the difference?

Odysseus

I'm still left wondering about this, is it really needed? I'm also wondering if any of this has come from the Health Research Board, I fill in a form for each person I see as part of my work with the addiction services so on average I send in about 10 forms a year for primaryily codeine, I'm sure this must add up when you consider most addiction treatment facilities fill in these forms.

However, the question must be asked when will we cop on that making things more difficult for people to obtain does not prevent those who have a problem with a chemical from getting it, it may make it more difficult but that is all imo.

A few times a year I may take a codeine based product that is in theory available OTC, I travel a lot hence I end up in different chemists, and tbh the looks I have got even with a prescription do give me a sense of what it is like for some of my clients. I was actually able to see it in one place when they told me they don't stock it. This was after the staff looked me up and down and as I was in my bike leathers clearly they didn't like the look of me. I actually seen them look at the product in question then have the assisstant come out and tell me the above.

I know in certain cases I have been viewed as a drug user and it does reinforce my belife that there is something very wrong with how drug users are treated in this country; never mind some poor soul who is in pain. After the last time I just rang a friend who owns his own chemit's and got it off him, and it looks like I'll be doing that again if I ever need it.

However, I can't believe this thread has made double figures:eek:

Odysseus

yogy wrote: »

What arguement? I simply asked for a source.




Nicotine is a replacement therapy for smoking, just as methadone is for heroin.

You do not get any hit/kick from Nicotine replacement products just as you don't from methadone, they simply help to deal with the cravings/withdrawl.

Codeine acts on opioid receptors, people get a kick out of this...some people will inevitably enjoy this kick too much and become addicted to said product.

Now do you understand the difference?

Now come on, I'm all for MMT, but if people didn't get a kick out of methadone there would be no such thing as primary methadone addicts and there are plently of them around. That is people who's first opiate was methadone, it's also why people take extra methadone.

yogy

Odysseus wrote: »

Now come on, I'm all for MMT, but if people didn't get a kick out of methadone there would be no such thing as primary methadone addicts and there are plently of them around. That is people who's first opiate was methadone, it's also why people take extra methadone.

But is it not different for those who's first opiate is not methadone?

What I mean is, if you or I were to take a shot of methadone this evening we'd probably sink into the couch. However if a heroin user with a bad habit is given a prescribed dose by their GP then it will do little more to them than stop the withdrawl?

Wagon

Eventually they'll just resrict everying. It won't work out well like this extremely plausable example shows...

Shopkeeper: "What do you want?"
Wagon: "Packet of those Triple X mints."
Shopkeeper: "Why?"
Wagon: "Because I want mints"
Shopkeeper: "Sorry, ill need a legitimate reason"
Wagom: "My breath smells bad"
Shopkeeper: "And what were you doing to make it smell bad?"
Wagon: "Just finished drunkenly muching on your wife's flange and want to get the flavour of 50 businessmen out of my mouth".

Then i wake up in the hospital with a broken nose and probably Syphilis.

Kurtosis

sesna wrote: »

As an aside I do find it amusing that one is legally not allowed to buy more than two boxes of paracetamol from a pharmacy, yet a drug addict can go in and legally get a few hundred ml of methadone, or a new clean needle to inject himself with heroin.

A patient can legally be prescribed methadone and collect it in a pharmacy (and often have to consume it there also). While there is no official pharmacy based needle exchange program in place, there is one in development, though there may be individual pharmacies currently operating a needle exchange.

All you've pointed out is three pharmacy harm reduction measures relating to drugs, I can't find the funny bit.

yogy

penguin88 wrote: »

A patient can legally be prescribed methadone and collect it in a pharmacy (and often have to consume it there also). While there is no official pharmacy based needle exchange program in place, there is one in development, though there may be individual pharmacies currently operating a needle exchange.

All you've pointed out is three pharmacy harm reduction measures relating to drugs, I can't find the funny bit.

+1

Odysseus

yogy wrote: »

But is it not different for those who's first opiate is not methadone?

What I mean is, if you or I were to take a shot of methadone this evening we'd probably sink into the couch. However if a heroin user with a bad habit is given a prescribed dose by their GP then it will do little more to them than stop the withdrawl?

Like most things it depends, most GP's are looking for a dose that will prevent the person from craving for another opiate, often this can mean that the dose they presribe is one that not only achieves that but some state of intoxification. Yes of course there are plently of people who only take enough to stop their desire for something else, but the are plenty of people who only achieve this through getting enough methadone to produce a desired effect within themselves.

Then you have a siginificant number of those who get extra methadone through other sources, they are taking it not to allievate withdrawal but to get stoned. At the end of the day I would rather have someone taking methadone than heroin, but I would argue that it's incorrect to say that people don't stoned on methadone.

It can get more complicated with people taking other substances such as benzos to enhance the effect of their methadone, I would'nt like to see this used as an arguement as to not giving a opiate dependant person access to methadone, but a significant amount of the people I see would acknowledge that they get more out of their methadone than just blocking withdrawal syndrome. However, in those cases if you where to reduce the amount, the person would resort to heroin use again.

sesna

penguin88 wrote: »

A patient can legally be prescribed methadone and collect it in a pharmacy (and often have to consume it there also). While there is no official pharmacy based needle exchange program in place, there is one in development, though there may be individual pharmacies currently operating a needle exchange.

All you've pointed out is three pharmacy harm reduction measures relating to drugs, I can't find the funny bit.

The funny bit for me is that you can buy 500 paracetamol in the USA for $5, or you can buy paracetamol from a supermarket in Ireland from a self-service checkout.

However quantity sold is restricted to two boxes in the same pharmacy that a drug addict can be legally supplied a drug that is as addictive as heroin.

As for your take on harm reduction of needle exchange/methadone, that is controversial at best.

sesna

yogy wrote: »

Nurofen Plus-Stomach ulceration

Solpadeine-Liver failure

both of which, if undiagnosed can prove fatal.

Now for a very quick lesson for you to try and understand the difference:
/QUOTE]

Only when taken above the recommended dosages, same as anything really. Also I note that both effects you quote come from non-codeine containing elements of the drug.

What evidence have you in Ireland of there being a problem with people exceeding recommending dosages of codeine-containing products? No study has been commisioned.

I read an article of a student who took 126 ProPlus Caffeine containing tablets. Why not put caffeine in these useless guidelines also given they are dangerous in overdose ?

yogy

sesna wrote: »

The funny bit for me is that you can buy 500 paracetamol in the USA for $5, or you can buy paracetamol from a supermarket in Ireland from a self-service checkout.

However quantity sold is restricted to two boxes in the same pharmacy that a drug addict can be legally supplied a drug that is as addictive as heroin.

.

You shouldn't post on topics you clearly no nothing about.

It is possible to get 240 paracetamol tablets on Rx in Ireland "in the same pharmacy that a drug addict can be legally supplied a drug that is as addictive as heroin". Quantity is not as restricted if you have a valid Rx.

Methadone is supplied on Rx only. It is not as addictive as Heroin.

You should quit while your ahead. (or in this case, way behind)

Lemsiper

sesna wrote: »

yogy wrote: »

Nurofen Plus-Stomach ulceration

Solpadeine-Liver failure

both of which, if undiagnosed can prove fatal.

Now for a very quick lesson for you to try and understand the difference:
/QUOTE]

Only when taken above the recommended dosages, same as anything really. Also I note that both effects you quote come from non-codeine containing elements of the drug.

What evidence have you in Ireland of there being a problem with people exceeding recommending dosages of codeine-containing products? No study has been commisioned.

I read an article of a student who took 126 ProPlus Caffeine containing tablets. Why not put caffeine in these useless guidelines also given they are dangerous in overdose ?

I accidently took around 600mg of caffeine in one dose. Possibly the least pleasant experience of my life so far.

yogy

sesna wrote: »

yogy wrote: »

Nurofen Plus-Stomach ulceration

Solpadeine-Liver failure

both of which, if undiagnosed can prove fatal.

Now for a very quick lesson for you to try and understand the difference:
/QUOTE]

Only when taken above the recommended dosages, same as anything really. Also I note that both effects you quote come from non-codeine containing elements of the drug.

What evidence have you in Ireland of there being a problem with people exceeding recommending dosages of codeine-containing products? No study has been commisioned.

I read an article of a student who took 126 ProPlus Caffeine containing tablets. Why not put caffeine in these useless guidelines also given they are dangerous in overdose ?

Oh dear God, this is fcuking cringe worthy!

sesna

yogy wrote: »

You shouldn't post on topics you clearly no nothing about.

It is possible to get 240 paracetamol tablets on Rx in Ireland "in the same pharmacy that a drug addict can be legally supplied a drug that is as addictive as heroin". Quantity is not as restricted if you have a valid Rx.

Methadone is supplied on Rx only. It is not as addictive as Heroin.

You should quit while your ahead. (or in this case, way behind)

Yes you can get 240 tablets on prescription, or even 1000 tablets on prescription. Do you always make such bullsh*t obvious points.

And also you are talking bollix again, methadone is as addictive as heroin (and gives you a high). Is this guy actually a pharmacist, Im getting really worried.

sesna

yogy wrote: »

sesna wrote: »

Oh dear God, this is fcuking cringe worthy!

Once again, for the third time, what evidence do you have of a problem in this country of people taking more than 8 tablets per day of Solpadeine, 6 for Nurofen ?

Or will it just be more boring, inane responses ?

AAAAAAAHHH

Greyfox wrote: »

Hope this isn't true, I've to get a tooth out and Nurofen is an absolute must for this, just the principle of having to pay a doctor to see me for 20 seconds while I explain this makes me sick

This might have been said but can't the dentist give you a prescription?

sesna

AAAAAAAHHH wrote: »

This might have been said but can't the dentist give you a prescription?

I presume so, I know I got an antibiotic prescription off dentist before. Might be a good idea to get one, and save yourself the lecture from the concerned pharmacist.

sesna

Lemsiper wrote: »

sesna wrote: »

I accidently took around 600mg of caffeine in one dose. Possibly the least pleasant experience of my life so far.

Forgot to add that the overdose was fatal for that student.

http://www.highbeam.com/doc/1G1-90962300.html

Odysseus

sesna wrote: »

yogy wrote: »

Once again, for the third time, what evidence do you have of a problem in this country of people taking more than 8 tablets per day of Solpadeine, 6 for Nurofen ?

Or will it just be more boring, inane responses ?

There would be evidence of people being addicted as I said above with the HRB forms, but that does not take note of quanity, but anyone I seen for the above would take more than the recommended dose. Your right in that the only evidence I would know of would come from other people in the same field.

However, whilst I would stand over my own experience, I had an elderly chap in with me yesterday, his used to put 12 in a glass at a time. The problem with anecdotal evidence especially if it is about drug use in Ireland is its very open to being used to push a psrticual agenda forward.

sesna

Odysseus wrote: »

sesna wrote: »

There would be evidence of people being addicted as I said above with the HRB forms, but that does not take note of quanity, but anyone I seen for the above would take more than the recommended dose. Your right in that the only evidence I would know of would come from other people in the same field.

However, whilst I would stand over my own experience, I had an elderly chap in with me yesterday, his used to put 12 in a glass at a time. The problem with anecdotal evidence especially if it is about drug use in Ireland is its very open to being used to push a psrticual agenda forward.

Only with proper knowledge of the extent of the problem can proportional response be formulated. How many addicts or misusers are there?

If there is only 100 codeine addicts in Ireland, then this guidance is overkill.
If there is 500,000, then it is hopelessly inadequate.

I read in one newspaper of research underway by UCC into codeine misuse in Ireland. However, this study merely gauges pharmacists opinions, there will be no hard facts.

bleg

sesna wrote: »

Also, I personally am not in favour of restricting every bloody thing, and would be the opposite actually calling for more stuff on prescription to be available without prescription such as oral contraceptives, cholesterol tablets, etc.

The reasoning behind the current IMB licencing of OTC products is that they are to be used in acute cases on a short term basis. Hence, aspirin for pain is available OTC at 300mg but the 75mg anticoagulant dose is POM. The reasoning is that you shouldn't be anything long term without your physician knowing it.

Also, what does 3 days maximum use mean? Does that mean I can use it for 3 days, take a twelve hour break and use it again for 3 days indefinetely. Or should I take a two day break, before buying it again... )

It should be used for the short term (3 day) management of acute pain. So you should go on it for 3 days, if the pain is gone then you're gravy, if not you should go see your doctor. That's the logic behind it anyway.

Kurtosis

sesna wrote: »

The funny bit for me is that you can buy 500 paracetamol in the USA for $5, or you can buy paracetamol from a supermarket in Ireland from a self-service checkout.

However quantity sold is restricted to two boxes in the same pharmacy that a drug addict can be legally supplied a drug that is as addictive as heroin.

As for your take on harm reduction of needle exchange/methadone, that is controversial at best.

I'm sure you're aware that in a non-pharmacy outlet per transaction you can only buy a single 12 pack of 500mg tablets with paracetamol as their only active ingredient, i.e. more restricted than in pharmacies. I don't really know why you've picked on methadone, the same pharmacy where you can only pick up two packs of paracetamol also dispenses plenty of other drugs that are highly toxic and can kill at small doses...so what?

I'm not sure you understand what harm reduction is. Because harm reduction is the primary purpose of methadone maintenance, needle exchange and limiting paracetamol availability.

sesna

penguin88 wrote: »

I'm sure you're aware that in a non-pharmacy outlet per transaction you can only buy a single 12 pack of 500mg tablets with paracetamol as their only active ingredient, i.e. more restricted than in pharmacies. I don't really know why you've picked on methadone, the same pharmacy where you can only pick up two packs of paracetamol also dispenses plenty of other drugs that are highly toxic and can kill at small doses...so what?

I'm not sure you understand what harm reduction is. Because harm reduction is the primary purpose of methadone maintenance, needle exchange and limiting paracetamol availability.

I picked methadone as it is a common street drug with huge addiction potential. Agreed, I could have picked another drug for the same reason.

Maybe you should look into long-term outcomes for methadone patients. It's not quite the wonder drug some pharmacists think it is. Thats what I meant by controversial. Also studies on benefit needle exchange programmes have been ambiguous and contradictory.

Also, please don't dwell on the point. It was presented as a minor aside which on one level was slightly ironic to me, so please treat it as such. I understand perfectly the reasoning behind the restrictions for each of the products, even if I dont always agree with them.

Odysseus

sesna wrote: »

Odysseus wrote: »

Only with proper knowledge of the extent of the problem can proportional response be formulated. How many addicts or misusers are there?

If there is only 100 codeine addicts in Ireland, then this guidance is overkill.
If there is 500,000, then it is hopelessly inadequate.

I read in one newspaper of research underway by UCC into codeine misuse in Ireland. However, this study merely gauges pharmacists opinions, there will be no hard facts.

By the time Ireland gets around to a proportional response to anything drug related I reckon I will be collecting my clock from the Addiction Services. Drug treatment in Ireland is a joke.

The HSE Addiction Services has only one inpatient facility available, all we seem interested in here is either drowning a person in methadone, [and I'm all for MMT, but lets try help those who want to get off it] or trying to ban substances or make them harder to acquire.

I would be interested to know what the rates of addiction to codeine or drugs like tramadol are like in the south of Spain when you can get them OTC.