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Codeine without a Rx?

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Mar 3rd, 2006, 09:14 AM
  #1
Havana
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Codeine without a Rx?

Can you still buy Tylenol/aspirin with CODEINE over the counter at pharmacies in Paris? I just read an old thread that said that practice was going to stop. Can anyone name a specific pharmacie (City Pharmacie?) where you can buy Tylenol w/codeine and cough syrup w/codeine without the benefit of a script?
 
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Mar 3rd, 2006, 09:39 AM
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I know you asked about Paris, but I believe that the Spanish brand I buy (Termalgin) exists there. You can get it with or without codeine at any pharmacy.

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Mar 3rd, 2006, 09:53 AM
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French law allows the sale of certain products containing codeine over the counter. They are all combination products (not plain codeine), and the doses of codeine are very low—far too low to produce any type of “high”.

Prontalgine is an OTC analgesic that you can buy in France for migraine; it's the same formulation as Tylenol #2 with Codeine. Migralgine is similar. Aspégic Codéine is harder to find (I presume aspirin is harder to sell than acetaminophen), but it contains aspirin in place of the acetaminophen. All of these contain about 15 mg of codeine per dose, which is very low. Keep in mind that a typical therapeutic oral loading dose of codeine by prescription is at least 60 mg or so, and sometimes more (although if more is required often some other analgesic is used).

There are a few cough preparations that contain codeine, also, in even smaller amounts than the migraine remedies.

The reason all of these are sold OTC is that codeine is useful for treatment of cough and pain and the doses of codeine are so low that they cannot produce a “high” outside of the patient's imagination. Furthermore, if one tried to overdose in order to get a codeine high from any of these medications, other ingredients in them would produce vomiting or severe toxic effects long before the necessary dose of codeine were absorbed. So there's no reason not to sell them OTC.

The French, like many other countries, realize that the rabid paranoia over all forms of narcotics that afflicts the United States is largely unjustified. Opiates are useful in moderation for certain purposes: analgesia, control of cough, control of diarrhea, etc. The doses required for these purposes are much lower than those that produce any type of psychoactive effects.

I confess that I worry when I see the eyes of Americans light up when they find out that they can buy pain relievers containing codeine over the counter in France. Don't Americans ever think of anything other than getting high on drugs? Do they even know that there are legitimate uses for codeine? The apparent fascination of Havana in the first post in this thread is the kind of fascination that worries me.
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Mar 3rd, 2006, 10:01 AM
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Maybe Havana is looking to purchase to use it for specific and legitimate reasons. I buy it for my mother and it used to really bother me when my friends would chime in "Ooh! Me too!". So, now I just don't mention it and no one asks for it.
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Mar 3rd, 2006, 10:06 AM
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Someone who writes CODEINE in uppercase letters sounds exactly like the type of American I've described, who just thinks drugs are so cool and it's so wonderful to be able to buy this trivial analgesic OTC. I've even had Americans who wanted to go into a pharmacy and buy something with codeine in it just so they could have something with codeine in it. Maybe they thought they could get high without breaking the law (but they can't—an OTC dose of codeine doesn't really have any psychoactive effect at all).

I don't understand this fascination with drugs. But I would suggest that any Americans who can't think of codeine being sold OTC without salivating or developing DTs should probably stay in the U.S. We don't need a U.S.-style drug culture in France.
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Mar 3rd, 2006, 10:07 AM
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Anthony, are you a physician or pharmacist? I just wondered because I am a health policy analyst and biostatistician, and am doing a project right now in the area of some OTC pharmaceutical products and have read some medical opinions that many OTC cough medications are really not recommended or necessary and can even be harmful, particularly ones that suppress a cough reflex which is not necessarily a good thing to do as coughs can serve a good purpose.

I'm not a clinician by any means, and so my question was WHY people think codeine, a painkiller, is an appropriate thing to treat coughs, as you claim yourself in your post. I have a German friend who raves about wanting codeine cough syrup, also, for some reason. Coughs are not usually painful, why would one need codeine in a cough syrup? From what I've read, the purpose of that codeine is to suppress the cough reflex in the brain and that may not be a good thing.

Anyway, I think you can get addicted or dependent on OTC cough syrups with codeine, although most people do not abuse them.

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Mar 3rd, 2006, 10:11 AM
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When I have a bad cough, the only thing that permits me to sleep several hours without interruption is cough medicine with codeine.

I am aware that coughs serve a purpose and should not always be suppressed. But a few hours sleep is desireable too.
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Mar 3rd, 2006, 10:24 AM
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Christina:
I am someone who was very greatful that we can get (OTC) cough syrup with codeine here in Canada. I had a cough so bad I injured the muscles in my chest wall and my throat. I am amazed that you think severe coughing is not painful. Without that cough syrup I would have been in constant pain and unable to sleep. My Dr felt that the best thing for me was OTC cough syrup with codeine. Believe me it works when nothing else does. IF a cough is non-productive and severe and especially if the cough is causing injury, OTC cough syrups with codeine
are recommended both in Canada and Britain.
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Mar 3rd, 2006, 10:48 AM
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Anthony- now that I see his numerous postings, I get your drift.
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Mar 3rd, 2006, 11:15 AM
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Havana, your postings really are looking a little desperate. Talk to your doctor if you feel like you need an occasional pain reliever. It's not an unusual request and not considered drug-seeking unless you're hitting the doc up on a regular basis ("I dropped them in the toilet", "someone stole them", "the pharmacy didn't give me the full rx"). I know someone who gets 10 vicodin and 10 xanax (anti-anxiety, like valium) a year and that is all a person needs for most healthy, non-chronic complaints.
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Mar 3rd, 2006, 11:17 AM
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Christina, codeine is not just a painkiller. Codeine is an opiate, like morphine, hydrocodone, and so on, and like all opiates, it has a number of effects besides analgesia that have therapeutic benefits. One of these effects is cough suppression, and codeine is particularly effective for cough suppression even among the opiates, often working where other medications do not.

While suppressing a cough (especially a productive cough or one that is persistent and has not been investigated) isn't a good idea, a dry, scratchy, benign cough can drive people crazy in short order. Codeine is an excellent remedy for this type of cough. It is effective in low doses for this purpose (doses below the analgesic doses, such as only 6 mg or so). This is why so many cough medications contain codeine.

Even the relatively innocent dextromethorphan is actually derived from opium. DM doesn't work as well as codeine, but it keeps people from getting paranoid about drug abuse, as it's pretty hard to abuse DM.

Anyway, in France you can get both DM and codeine-containing medications for cough. Pharmacists will generally suggest DM or other meds before they resort to codeine. Medications in both categories are available OTC, although very strong codeine preparations require a prescription (and this makes sense, since you really need to find out why you are coughing if you need a suppressant that strong).
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Mar 3rd, 2006, 11:35 AM
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When I get a cold, it invariably goes to severe bronchitis, and cough syrup with codeine is, as others have mentioned, the only thing that allows me to sleep a few hours at night, and sooths the sharp pain in my throat every time I do cough.

Not everyone that seeks pain medication is a drug addict.
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Mar 3rd, 2006, 11:56 AM
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"I confess that I worry when I see the eyes of Americans light up when they find out that they can buy pain relievers containing codeine over the counter in France. Don't Americans ever think of anything other than getting high on drugs."

Gee - thanks for the massive and sweeping over generalization of Americans.

You must feel so important when you lecture us.
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Mar 3rd, 2006, 12:10 PM
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Remind me to tell you about the phenomenal and legendary hypersensitivity of Americans to criticism sometime—they are famous around the world for being ready to dish out criticism, but being completely unable to take it.

Anyway, you don't notice the drug culture in the U.S. because it permeates the entire society. Everyone says drugs are bad, but practically everyone has used them, and allusions to drug use are continual in the U.S. and almost invariably made in a positive way, as if taking drugs were cool, instead of being a mental illness. This is why the U.S. has a huge drug problem, whereas many other countries do not. The country has made great strides in rendering smoking socially unacceptable; if it could just apply the same logic to alcohol and other illicit drugs, about 80% or more of the crime in the country would evaporate.

So feel free to visit France; but please leave the doper culture at home.
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Mar 3rd, 2006, 12:33 PM
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Excuse me AnthonyGA, I usually just ignore your posts but your comment that pratically in the US has used drugs goes way over the line. And is false as well. Your distaste for American's borders on being a fanatic. And don't bother answering because I am not going to respond. I just don't respect a lot of your thinking.
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Mar 3rd, 2006, 12:57 PM
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I have a distaste for drug abuse, not Americans. Unfortunately, most of the American population abuses drugs to some extent.
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Mar 3rd, 2006, 12:58 PM
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AnthonyGA,
You really believe virtually all Americans have used drugs?? How about this then - I am 26 and I can only name ONE person out of all my friends, family members, and acquaintences that has ever used any sort of drug (and yes, I am including marijuana in that list).
What an idiotic generalization
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Mar 3rd, 2006, 12:58 PM
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"most of the American population abuses drugs to some extent."!! C'mom mate we can all do a bit of yank bashing now and then but at least we some facts to support it
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Mar 3rd, 2006, 01:11 PM
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I wonder how much your perception of America's fascination with drugs as compared with other countries is legit.
Maybe more publicized and otherwise out in the open vs. not acknowledged or not as condemned. That is, illegal drugs.
We definitely have a culture being trained from birth by the pharmaceutical companies to turn to a pill (and other methods of delivery) for relief of any sort of discomfort or symptom. I wonder if the pharmacy companies are attacking Europe with bladder control and allergy ads?
I've seen ads for meds that I don't have any idea what they are supposed to treat. But they suggest I should go to my doctor and ask if I need it. Which I imagine probably works because those pharaceutical companies know advertising ploys better than anyone.
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Mar 3rd, 2006, 01:24 PM
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Alcohol is a legal drug that can have a much more deleterious effect than some illegal drugs. Whether a drug is illegal or legal matters little as it should be its beneficial and negative effects - that America is swarming in illegal drug use, allegedly in some posts here, perhaps means that we have more drugs that are illegal than other countries. The knee-jerk politicans reaction to marijuana, classified as a step 2 narcotic i believe much like opiates by the federal government is simply hypocritical - the Dutch example separates hard drugs like heroin and cocaine from soft drugs like marijuana and alcohol, which i think is a wise decision. If America is awash in illegal drugs it's even more awash in legal drugs like alcohol and nicotine, both much more lethal and dangerous to the health than marijuana in any objective view. That's my opinion and let's avoid name calling and express opinions without malice.
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