CLL Support Association
8,912 members14,229 posts

What you need to know about strong pain killers

What you need to know about strong pain killers

When you need a strong pain killer, how do you choose what’s best for you? And what are the side effects?

Michael Vagg, Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health, Victoria, Australia, describes the common ingredients of strong pain killers, how they work in our bodies (it varies by individual) as well as some of the more common risks associated with these drugs including some tips on addiction risk.

Of particular interest:

"Codeine is a naturally occurring opioid with a very long track record of relatively safe use. It constitutes around 3% of the alkaloids found in opium juice, but is synthetically derived for medical use.

Codeine has relatively poor analgesic ability by itself. Most of the painkilling effect of codeine is produced when metabolised by the liver. An average person will produce around 1mg of morphine from the 10 to 15mg of codeine in many of these over-the-counter analgesics.

But there is major variability in our ability to metabolise codeine. As many as 25% of the people in the community are unable to produce morphine from codeine and therefore will get very little pain relief. But they will endure the same side effects.

A much smaller percentage will be very active metabolisers who will produce a far higher percentage of morphine from the same dose.'"


3 Replies

I found this article very useful and informative Neil because no GP has ever told me that the liver makes morphine from ingested codeine (in some people anyway it seems).

Sometimes I do wonder if GP's fully appreciate the interactive effects of medication so it's important to keep ourselves as well informed as possible.

The responses to the article were useful to read too so thanks for posting.

* As an aside Neil I've just noticed your suggestion for an alternative Australian national anthem. Haunting song with powerful lyrics...



This was very interesting, as it might explain why my husband got little or no relief from the pain caused by shingles when taking the prescribed medication his GP gave him.


Weekly Dose: codeine doesn’t work for some people, and works too well for others; Olaf Drummer, Professor, Forensic Medicine, Monash University, explains why:



You may also like...