Bible Science Forum

How I got addicted

About 15 years ago I started to develop leg pains. I sought medical help and after much investigation the doctors could not diagnose the cause. In the early years with this developing pain I started taking the over-the-counter paracetamol as a reasonably effective pain-killer but I became tolerant of the paracetamol and the pain developed to the point I needed to find something else for relief. Doctors suggested various drugs and even acupuncture without success.

About 6 years ago my doctor started me on prescription pain-killers, where each tablet contains 500 mg paracetamol with 30 mg of codeine. Codeine is an opiate, a morphine derivative; it, in fact, is converted to morphine by the liver. Codeine is a drug of dependency, but no doctor told me about the downside of taking this medication long-term. More on that later.

Initially I’d only take one or two tablets per day and it was reasonably effective. Also I took up walking a lot as that seemed to alleviate that pain, while I was walking at least. But as time passed the effectiveness of the codeine reduced and I increased the number of pills per day. By 2014 I was taking 4 per day and by 2016 it was 6 per day and even some times 8 pills.

In 2013 a new doctor diagnosed the cause of the pain as peripheral neuropathy resulting from untreated coeliac disease, which I have apparently had my whole life but only started to manifest symptoms about 15 years ago. About 6 years ago I was formally diagnosed with coeliac disease and have been on a gluten-free diet ever since. But the damage to my nerve fibres was done and I was told I could only mask the symptoms with strong pain-killers.

For the most part I was able to manage with the daily pain and some relief using the codeine pills. However in the last 4 years there were times where I started to develop unexplained symptoms like headaches, digestive problems (even though on a strict gluten-free diet) and a very unwell feeling, but they would come and go.

Pain goes to my head

Then on my last trip to Japan in March/April 2017 I started to feel ill almost daily, and by early April headaches started to develop. I developed not only what you would call tension headaches but something like ‘brain fog’, which was very disconcerting.  I noticed myself taking the codeine pills just to try to relieve those bad headaches. The headaches developed into migraines and it became difficult to do my job there, working at a national research facility AIST in Tsukuba.In the evening of April 19, I felt so ill, nauseated with head and neck pain, that I called my Japanese host to take me to the hospital. We spent most of the night there where they investigated with a CT scan and finally a MRI. Those tests cleared me but they gave no diagnosis, saying the head pain was probably muscle related.

However the next day I decided that whatever was making me sick was too much for me to bear in Japan and I planned my early return from the 60-day JSPS fellowship—cutting it short by 6 days. I was booked to leave Japan Sunday night April 23.

On April 22, 2017, I was expected in Tokyo, to present two lectures at a biblical creation seminar. The night before I emailed the organisers, and asked for them to pray for me, as I was feeling so unwell that for the first time in my life I considered pulling out of a seminar.  The morning I needed to catch the train to Tokyo God told me “as they went they were healed” (Luke 17:14).

So I obeyed and went to the train station and by the time I got to the train to go to Tokyo (a 40 minute ride) I had no headache and was well enough to proceed. I arrived at the seminar and was able to effectively give my two lectures with a 2 hour lunch break between where I had no problem from headaches or the sick feeling. I consider that an answer to prayer. Then soon after I sat down, after my second lecture was over, the ill-feeling started to return as well as the headaches. God gave me sufficient grace for the moment to get me through that. Thank the Lord!

Medication-Overuse Headaches

After arrival back in Australia I the headaches actually got worse. By this time I was experiencing 24 hour chronic migraines that were very debilitating. I even imagined that my time in this world was not going to be for much longer.

I went to my doctor and explained about the CT scan and MRI in Japan. He was not concerned of anything life threatening. But that doesn’t help as much as you might think when you are so brain-fogged and suffering chronic migraines. We examined options like amines in foods, which can cause migraines in some people. But I had not changed my diet much at all so why should these migraines develop?

The doctor gave me a new drug to try—eletriptan, which is a headache, anti-migraine medicine that narrows blood vessels around the brain. And it did enormously reduce the pain of the migraine. But the triptans are also drugs of dependency. I wasn’t too excited to start another medication, especially without knowing the cause.

So here I was still feeling ill, but with reduced headaches, and taking a lot of drugs of dependency, which can do damage to the liver. I went back again to my doctor, seeking further advice about anything else I could do, because restricting my diet further, to eliminate all amines, salicyclates and glutamates, didn’t help. The doctor basically told me there was nothing else anyone could do. I had tried alternative drug types, and acupuncture. Stronger opiate drugs were just not an option.

I remember walking out of that doctors rooms thinking: “Well, man cannot do anything else; it must be time to start trusting God.” It wasn’t like I had much choice.

As I drove back home, one thing the doctor had said, as I stood in the doorway of his office, on my way out, was that all those opiates are poisons as are triptans, and it has been scientifically documented that they can cause as much pain as they relieve.¹ Wow! (And this includes the over-the-counter paracetamol.) The fact of this rebound effect is established in the medical literature. The drug relieves the pain at one moment but gives it all back to you later, especially in those who use pain killers for a chronic condition, like myself.

That was Friday May 12^th. On that day was the last day I took codeine and an eletriptan pill. That was 9 days ago now. I have not taken a single pain-killer of any type since that day—in fact, I took the large quantity I did have and threw them in the garbage bin.

The reason I did this is because on that Friday, I read on the web about medication-overuse headaches (MOH).²  This relates to drugs that are associated with the development of chronic daily headaches and they include caffeine, ergots, paracetamol, codeine and the triptans. Their long-term use may be damaging to the liver and kidneys. In my case it made me very unwell, lacking of any energy, chronic migraines and disturbed digestive system.

According to Wikipedia,³

“MOH is a serious, disabling and well-characterized disorder, which represents a worldwide problem and is now considered the third-most prevalent type of headache. Population-based studies report the prevalence rate of MOH to be 1% to 2% in the general population, but its relative frequency is much higher in secondary and tertiary care.”

The only way of treating this condition is to stop the medication. Some people will stop the drugs immediately, others may taper them and others may even need to be hospitalised for detoxification under medical supervision.

‘Cold Turkey’

I decided to go ‘cold turkey’ – complete cessation of all medications, no matter what. I couldn’t contemplate having the headaches any longer. I wasn’t going to stretch out the detox process to make it easier but have the headaches even longer. Now my story really begins. And I suffered the typical acute opiate withdrawal symptoms that anyone taking heroin would suffer.

I really prayed and had confidence from God that I needed to quit completely and never to take those pain medications again. God told me that He would see me through. On the second day after quitting, one of the worst days, my son Ben prayed for my healing. That prayer, I can say now, was answered.

The first night after quitting was not any different because it was like my normal state with the drugs in me. I was able to sleep ok, despite the migraines. During that next day though I developed diarrhoea, and progressively pain throughout my body, especially a sort of nervous ache in my arms and legs. The diarrhoea was very bad and lasted nearly 6 days. I lost 4 kg in weight as I ate essentially nothing for 4 days—only drank juice and water.

The second night I was wide awake all night and feeling very ill. In fact, I never slept at all for 3 nights (72 hours) straight. By body was tired but my mind could not sleep. On the 4^th night I slept 1 hour and the 5^th night 2 hours (and I was overjoyed with that). It is amazing that I could still function after 5 nights with only 3 hours sleep in total. Though feeling extremely tired in the day I could still think, and now much more clearly as the ‘brain fog’ was lifting.

One thing that kept me from sleeping was the nervous aches in my limbs. It was partially relieved with hot compresses and walking around the house. I read online that the expression ‘kick the habit’ is a direct reference to the feeling you have to kick your legs and move your arms about. The agitation one feels comes from the brain trying to restore normal function of its opioid⁴ receptors. Because while taking opiates (codeine in my case) the brain does not manufacture the natural opioids. The receptors are wide open with no opioids to attach to. This is what causes the other acute opiate withdrawal symptoms, all of which I experienced including cramps and cold sweats and aches throughout my body. Those were mostly on the second and third days after quitting.

By the sixth day the headaches were reduced by at least 80% but still coming and going. I knew I was on the right path to full recovery, and I was through the most acute stage. Still that night I only could sleep 2 hours; really it was the following morning after staying awake all night. On the 7^th night I got 3 hours of sleep but the 8^th night I slept over 5 hours. During the waking periods it was still post-acute symptoms that kept me awake. Nervous aches in my arms would come and go in severity.

May 21 is my 9^th day since quitting the drugs, but from what I read, post-acute symptoms can last for months, even years, as the brain re-estabishes normal function. But having gotten some real sleep for the first time last night, I know I am on the correct path. Trust in God kept me through the darkest moments when I cried to my Creator to deliver me from what felt like torture. I believe that over the next week clarity of thought will be further strengthened and the headaches will further fade.

This leaves me with the original pain in my legs now being untreated. But let me tell you this. I would rather live with that pain than the brain-fog and migraines I experienced. I now pray for my God to deliver me from those leg pains without medication. Man cannot help so I suppose it has come down to that. I am eagerly waiting for God to act.

Update May 28: This is the 16th day after quitting the pain medications. Four days ago I slept 9 hours and have slept between 6 and 8 hours each night since. I only have short periods of post-acute symptoms: mild headaches and aches in my left arm (strangely not the right arm).

References

1.  Kudrow, L., “Paradoxical effects of frequent analgesic use”. Adv Neurol. 33: 335–41, 1982.
2. Medication-overuse headache, the migraine trust
3. Medication overuse headache, Wikipedia, accessed May 21, 2017.
4. Opioids are drugs that act on the nervous system to relieve pain. The term is in reference to any opiate type chemicals, which includes those made from the opium poppy (morphine, codeine, heroin etc) as well as any man-made synthetic chemicals.