One night last year, I lay in bed next to my boyfriend, waiting for him to fall asleep. Once he had dropped off, I leaned over and grabbed my bag from his side of the bed, and started frantically searching through empty pill boxes for a fresh pack of the strong painkiller co-codamol.
The noise woke him up and he just looked at me. “You took some before bed. Why do you need more?” he asked.
“I’m in pain. Go back to sleep.” I turned away, still rifling through the bag.
“Katie, I’m scared that one day, you’ll take so many tablets that you won’t wake up again.”
His words hit me like a smack in the face.
It all started when I was 16 and was rushed to hospital with what the doctors thought was appendicitis. I was at home watching Coronation Street, when, out of nowhere, I felt a stab of intense pain in my right side, like I’d been kicked in the stomach.
I was taken into surgery to remove my appendix but it turned out the mysterious pain wasn’t appendicitis after all. Doctors then put it down to a burst cyst on my ovary, which they removed in surgery. I came around in a hospital bed feeling groggy, with my worried dad sat beside me.
The next day, I hobbled out of hospital, clutching a prescription for co-codamol which I had been told would ease my pain.
Nine years later, my life would revolve around those tablets.
The NHS says that it’s possible to become addicted to the codeine in co-codamol but it’s rare if you’re taking the painkiller under medical supervision. It comes in three strengths, with the strongest (the type I had), only available on prescription.
After the operation, I felt relieved. I’d had the cyst removed, surely the pain would fade away in a matter of days with the painkillers, I thought. But it didn’t - if anything, it got worse.
My parents aren’t together, so it was just me and my dad at home. After a few days of me being in agony, he drove me back to hospital. I was prescribed more co-codamol and told to keep an eye on the pain.
Doctors over-prescribing strong painkillers is contributing to a “mounting health and social crisis” in countries like the US and Canada, with England and Wales also impacted, according to a recent report by the Organisation for Economic Co-operation and Development (OECD). The UK now has the world’s third fastest-growing rate of opioid use, the research also said. Last year, a BBC investigation found that GPs in England prescribed almost 24 million opioids in 2017 - a rise of 10 million prescriptions from 2007, leading a drugs counsellor and former user to claim that the NHS was "creating drug addicts".
The numbers of overdoses and deaths are also soaring, according to research by The Sunday Times. An investigation suggested that five people a day in England and Wales, with opioid deaths up by 41% in a decade to 2,000 a year. Although the majority of those deaths are linked to the illegal drug heroin rather than prescription medication, the OECD report does say that an increase in prescription and over-prescription of opioids for pain management is among the factors driving the crisis.
For me, it was the start of my struggle with severe endometriosis, a condition which causes the tissue that lines your womb to grow in other places, like your ovaries. It took me nearly six years and countless hospital visits to finally be diagnosed. This isn’t unusual - despite it being the second most common gynaecological condition in the UK, it’s notoriously difficult to diagnose.
At first, I took the recommended dose of co-codamol. But before long, I found I was obsessing over the tablets. I would itch to take more as soon as I’d had a dose and would ask my GP for new prescriptions at the end of every appointment.
It’s hard to explain how the tablets made me feel. They numbed the pain but it was more than that. My brain was foggier when I was on them, which reduced the panic I felt about not knowing what was wrong with me. Looking back, it was a horrible, disorientating state to put myself in.
After that first hospital visit, my life was full of tests and operations while doctors tried to work out what was causing my pain. In the wake of each surgery, I would be sent home with a box of pills. I’d always call the hospital back and ask for more, saying I was still in pain.
Increasingly, I felt like I needed painkillers to be able to function normally. Every morning, I’d stuff packs of co-codamol into my schoolbag, making sure I had more than I needed just in case. I remember my dad asking me as we sat down for tea one night why I needed so many tablets. I brushed it off but I could tell he was worried.
Looking back, I relied on the tablets because it felt like I was losing control of other things in my life. I couldn’t sit in classes and concentrate all day because of the pain, so I couldn’t complete my A-levels. I got a part-time job in a clothes shop but I had to call in sick constantly. I still didn’t know what was actually wrong with me. And on top of all of that, Dad started getting ill.
He had been complaining for a few weeks of pain in his legs and feeling tired but we both just put it down to stress. He went to see his GP and was referred to hospital for tests. Then one day in November 2011, when I was 19, I got a phone call which changed everything.
I was at work, bringing clothes from the storeroom to hang up, when my mobile rang. It was Dad.
“Katie… I’ve got some bad news. I’ve got prostate cancer.”
I dropped the armful of clothes I was holding and ran home.
When I burst into the house, shaking and crying, I found that my dad wasn’t back from the hospital yet. Standing there all alone, there was only one thing I could think to do. I took two co-codamol.
I started caring for Dad, doing the food shopping, keeping the house clean and tidy - all while battling my own pain. The tablets were the only thing I had control over - taking them gave me a few minutes of numb relief.
Despite doctors catching his cancer early, things took a turn for the worse. Eleven months after his diagnosis, Dad died suddenly in hospital.
The days after his death were a blur. Family came round, people brought food, but most days I lay in bed feeling completely numb. There was only one thing I thought might help me cope - upping my dose of co-codamol.
It started slowly. I just took a couple more. Then a couple more.
I knew what I was doing was wrong, that the dosage was too high but I didn’t care. I just wanted to feel numb. I called it my co-codamol cloud - I’d feel a foggy sensation and be able to briefly float away from the heartache. But it never lasted long enough, the pain of losing Dad would creep back soon after I’d taken a dose.
The side effects of the drugs - the most common of which are constipation, feeling sick and sleepiness - were horrible. I’d often have to take a break at work and run to be sick. I was constantly constipated and felt spaced out all the time.
One night when I was 21, my friend invited me on a girls' night out to a local bar. As we got ready together in her room, she ran through her night-out checklist: ID? Check. Money? Check. Phone? Check. But my checklist was different. Co-codamol? Check. Another pack just in case? Check.
I had learnt to be secretive so my friends didn’t even notice - I’d take them in the club toilets or sneak one when friends went to the bar. Drinking alcohol with the tablets only increased my high - I felt like I was floating. Occasionally, taking the two together would make me sick and I’d throw up outside the club. Everyone thought I’d just had a few too many - only I knew the truth.
I was finally diagnosed with endometriosis and polycystic ovary syndrome (PCOS) in 2014, when I was 22. I had further surgery and the doctor found that my right ovary was fused to my pelvis. That operation really reduced my pain, and I started feeling like my old self again. I even started to decrease my co-codamol intake, going back to the recommended dose. But it didn’t last - the tablets had too strong a hold on me.
I was depressed, still reeling from losing my dad and I soon fell into a difficult relationship that had a negative impact on my self-esteem. I turned to the painkillers. I thought they were my one escape from pain - physical, mental, anything. I started increasing my dosage faster this time and, within a few weeks, it had shot up to two-and-a-half times the recommended daily dose. It felt like the pills were always there for me and, when my relationship broke down, I leaned on them heavily.
Things started to get better when I met my new boyfriend in 2017. I was 24. We got chatting at a party and started seeing each other soon after. I was happy - finally, something in my life was going right.
I told my boyfriend early on that I needed the tablets for my endometriosis and tried to make the amount I was taking seem normal. But when we started living together, I found myself hiding tablets from him. I never spoke to a doctor about how I was feeling. At my lowest point, in 2017, I was taking triple the recommended dose.
Looking back, I was a mess. On that fateful night last year when my boyfriend woke up and caught me looking for pills in the middle of the night, I realised, in that moment, he was seeing me for what I was - an addict. I’d become so good at hiding my reliance on the tablets that I didn’t even think my boyfriend noticed.
The next day, I decided to get help. I rang my GP, who referred me to FRANK, a national drug education and information service. They pointed me towards a centre which helps people kick addictions through counselling and guidance.
I started seeing a support worker there. He was completely non-judgemental and spoke to me about my dad passing, my past relationship and how my reaction to these events drove my addiction. With his support, I decided to give myself a deadline - it was November 2018 and I was determined to kick the addiction by 1 January 2019.
At first, I was terrified. On days at work, I’d stare down at the little white pill in my hand, hating it, hating myself, not wanting to take it, knowing I would eventually give in.
The withdrawal was awful. I felt constantly sick, tired and irritable and I’d fly into a rage at the slightest thing. Some days I couldn’t physically get out of bed and whenever I was in pain, I’d have to battle with myself not to take the pills.
Eventually, I did it. By the end of the year, I was clean. I thought of my boyfriend as I took fewer and fewer pills and finally reached zero.
When I asked them about doctors’ handling of prescription painkillers, the Royal College of GPs said doctors were “highly trained to prescribe and will only do so after considering the physical, psychological and social factors potentially impacting on the health of the person sitting in front of them”. They said there was “no easy cure” for chronic pain, and that sometimes opioid-based drugs were the only things that could provide relief to patients, despite the risk of addiction. They also said GPs didn’t want patients on medication for long periods of time, so they’d aim to prescribe the lowest dose for the shortest period of time, invite patients for regular medication reviews and prescribe alternative treatments where possible.
But I do think more needs to be done to make sure people know about the devastating effects the pills can have on your life if you become hooked. I didn’t choose to be a painkiller addict - it crept up on me slowly until it was out of control.
Now, I’m almost 200 days clean and every day I remember to tell myself how far I’ve come. I finally feel healthy and alive for the first time in 10 years. My boyfriend and I are getting married in the summer. The co-codamol version of me was a walking, talking zombie - I couldn’t be happier that she’s gone.
Sometimes, I find an old empty packet under the bed, or stuffed down the sofa. I’ll look at them for a moment and think about the hold they had over me. Then I scrunch the packet up and chuck them away.
As told to Eleanor Layhe
If you have been affected by any of the issues raised in this article, information about help and support is available here
To hear more about the growing problem of prescription drug addiction in England listen to Radio 4's File on 4 - Opioids: A Painful Prescription?