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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 31213
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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I am very concerned about my husband. He has anxiety

Customer Question

Hello, I am very concerned about my husband. He has anxiety and depression and possible bi polar (not really had a firm diagnosis from a doctor). He has been percribed venofaxine, pegaboline and codine for this in the past. He was very addicted to codine and stopped taken codine and pregaboline in the Autumn. he stopped venofaxine for a while but is now back on it again. A week ago he went to the doctors because in the last couple of weeks he has been started taking cocodamol and his doctor has given him more codine. She told him that if codine helps then he should just keep taking it long term and when he said he didn't want to keep taking it she said she would put him on suboxone. I am really worried. I fully understand that i am not a doctor, but i see the state he gets in when he takes lots of codine and can't see how it can be a long term thing. I have been reading up on the suboxone as well and understand that it helps addiction, but wonder if he will just become reliant on that, it also seems a little overtop as he has only been taken codine for again for the last two weeks and before that didn't have any for 6 months.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Chip replied 2 years ago.

Hi. I understand your concern here.

Are you saying that with the codeine he takes more than the way it is prescribed?

And why does the need the pain medication?

Customer: replied 2 years ago.

He has been told by his doctor that he can take as much as he likes of the codine. It is not prescribed for pain at all. He has some anxiety issues and i suspect mild bi polar and he started taking over the counter cocodamol because it made him feel better. He realised this was an issue as the amount of paracetamol he was taking in the cocodamol could be harmful and went to speak to the doctor and she said she would prescribe him just codine on its own and he could have as much as he likes basically. I went with him and heard her say this. she said the codine was not as bad for him as pregabaline (which she prescribed for anxiety). I really feel bad questionning her as i am certainly not a doctor, but i am really beginning to question her judgment and am worried she might just end up giving him a problem with suboxone as well. Other doctors he has seen have said that codine should not be continually taken and have even refused prescriptions which makes me question her judgements as well. I think that part of the issue could also be that my husband will say different things to the doctor depending on his mood. sometimes he thinks he's he has been feeling depressed for weeks, when it has only been a few days. When he is hyperactive he will say everything is great and he feels normal (but that is usually only for a week). I notice long periods when he is normal and happy, but he completely forgets about them when he feels either low or high and will tell the doctor that is how he has been feeling for ages.

Expert:  Dr. Chip replied 2 years ago.
I understand. Has he see a psychiatrist for his mood problem?
Customer: replied 2 years ago.

Yes a few years ago. The psychiatrist said he might have bi polar but because he is able to function normally (job, married, home owner etc) she felt there was nothing more that could be done and he only saw her for 1 hour. My husband will often not recognise there is an issue. He will admit that he has anxiety and sometimes depression and this week he has said he feels very high (not sleeping etc) and he admits he has been addicted to the codine she prescribes him. Sometimes he will agree to see a therapist and we even asked for a private referral to a psychiatric last year, but in a few days time he feels better and cancels the appointment. He has agreed to see a therapist again, but i am just not sure if i should try and stop him going on suboxone, or at least get him to seek an opinion from another doctor on the matter. He is not keen to seek another opinion, as he knows they will tell him to just stop the codine.

Expert:  Dr. Chip replied 2 years ago.
OK. First off I think it is totally inappropriate for his doctor to be prescribing him codeine for his psychological problem and even Suboxone--which is also addictive--would be inappropriate. He needs to revisit a psychiatrist and have appropriate medications prescribed for his possible bipolar disorder. I too question the judgment of his doctor and I think it would be best for him to also see a different general practitioner
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Customer: replied 2 years ago.

The doctor would be prescribing the suboxone to help him come off the codine (not for psycological problems). However, would you judge this to be appropriate when he has not been taking codine since November and only started again a few weeks ago? i am worried it will create a new problem and i am thinking that maybe just stopping taking codine and having a few days feeling a bit ill and possibly getting some therapy might be better. It is not like he is on heroine!

Expert:  Dr. Chip replied 2 years ago.
He doesn't need the Suboxone right now--he can just stop the codeine. And I agree that the Suboxone would only be a bandaid and would cause as much of a problem as the codeine.

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