Pain Pills Are Not "One Size Fits All"

Millions of people are given medicines that contain codeine every year, as it has become one of the most commonly prescribed drugs for pain here in the US. This addictive substance is often used to "treat" individuals with chronic pain, and in addition to the many hazardous side effects of codeine (it is particularly toxic to the liver), research now indicates that its effectiveness may vary greatly from person to person based partly on genetic and racial factors. It appears that certain people are at higher risk for dangerous side effects from codeine as well.

The widespread use of a drug like codeine is a perfect example of really bad medicine. I wonder how many people who are prescribed codeine are told that it is not a long-term answer for chronic pain, but in fact will introduce further health complications from ongoing use, and will do nothing to correct the issues that are causing the pain in the first place. Many doctors will write a script for codeine simply because chronic pain is such a common symptom in many of their patients and these physicians do not know what else to do or do not care enough to help these men and women who are trusting in them for a solution to find real answers to the underlying factors that are causing pain. I would venture to guess that a large percentage of individuals who are on codeine could greatly reduce their pain levels simply from shedding extra pounds and learning how to stretch and properly exercise their bodies. The tragedy is that once people begin to use a drug such as codeine, they lose what little impetus they may have left to get up and move in ways that will lead them towards wholeness. Instead of pursuing health and wellness, codeine users are often given a cocktail of added drugs to deal with the side effects, thus putting their systems even further out of balance.

If you suffer from chronic pain I encourage you to look into alternative ways of dealing with it rather than getting hooked on drugs. Many people are having great success with treatments such as massage, exercise, hydrotherapy, physical therapy, chiropractic care, bioelectric therapy, stress management, natural-foods based diet, and other options that will build you up instead of tear your body down through the use of pharmaceuticals.


Genetic Factors Affect Codeine's Work as Painkiller
Fri Jun 6, 11:47 PM ET

FRIDAY, June 6 (HealthDay News) -- The popular painkiller codeine can be ineffective or, worse, cause serious reactions if you are among those people whose bodies do not process the medication properly.

The liver converts codeine into morphine using the enzyme CYP2D6, a process that causes pain relief in most people. However, genetic differences in some people cause either too much or too little of the enzyme to be produced, resulting in less than pleasant results, reports Public Citizen, a national, nonprofit consumer advocacy group, in its June Worst Pills, Best Pills newsletter.

People whose liver's produce higher than normal CYP2D6 levels convert more of the codeine into morphine -- a situation that could cause excessive sedation, severe constipation and other side effects. While this only occurs in about 4 percent of Caucasian North Americans, prevalence is much higher in people from Greece and Portugal (10 percent), Saudi Arabia (20 percent) and Ethiopia (30 percent).

People with less CYP2D6 find little or no relief from codeine, because the liver does not convert enough into morphine. This happens in about 6 percent to 10 percent of Caucasians, 3 percent to 6 percent of Mexican-Americans, 2 percent to 5 percent of African-Americans and about 1 percent of Asians.

"When one adds the number of people who are genetically deficient in CYP2D6 to the number of people taking medications that inhibit CYP2D6, it is clear that a significantly large group of people are at risk of a suboptimal response to codeine," Sidney Wolfe, director of Public Citizen's Health Research Group, said in a prepared statement.

Certain medications can also affect one's CYP2D6 activity. The enzyme's production is inhibited, for example, by: diphenhydramine, a common antihistamine sold over-the-counter as Benadryl; and quinidine, a medication used to treat abnormal heart rhythm and sold under the brand names Duraquin, Quinaglute, Dura-tabs, and Quinidex, the report said.

Testing one's CYP2D6 enzyme level is neither routinely available nor affordable, so patients taking codeine for the first time should use caution and watch for signs of an excessive response, such as sedation, respiratory depression and gastrointestinal effects, Wolfe said.

"All inadequate or excessive responses to this drug need to be reported to a physician," Wolfe said.

More information

The U.S. National Library of Medicine has more about codeine.

http://news.yahoo.com/s/hsn/20080607/hl_hsn/geneticfactorsaffectcodeinesworkaspainkiller&printer=1;_ylt=AnU6i4fOgc3S7VfeMd3po3y9j7AB