Experiences with Prescription & Over-the-Counter Drugs
Preferred Name: Sean
Gender: Male
Age: 48
Background:
Sean works in education and lives with his partner and their children. He describes his ethnic background as ‘Anglo-Australian’: he and his parents were born overseas.
Brief Outline:
Throughout much of his thirties, Sean took heroin, ice and cocaine, typically with friends, sometimes in relationships, and also alone. His drug consumption changed when he began a new relationship in his late thirties. A few years after the birth of his first child, Sean’s mother died. He says he began taking Nurofen Plus® (a combination of ibuprofen and codeine) in ‘larger and larger amounts’ as an ‘emotional regulator’. Over the next few years, he tried to reduce his consumption of Nurofen Plus® through a ‘reduction regime’ with his GP, but this was unsuccessful. He’s since stopped taking Nurofen Plus® after being prescribed opioid pharmacotherapy treatment (buprenorphine).
In his early forties Sean’s mother died, and he began to feel like he was in an ‘impossible’ situation in his relationship. He began regularly taking Nurofen Plus® in ‘larger and larger amounts’. He says, doing so gave him a ‘nice, warm glow’ for a few hours, and acted as ‘an emotional regulator’ that could temporarily ‘resolve’ his ‘negative’ feelings. This enabled him to ‘focus’ and ‘function’ at work.
After a number of months, however, Sean felt that his consumption of Nurofen Plus® had become ‘more complicated’. Increasingly, taking a packet of tablets would make him ‘just feel normal’. Not wanting to continue taking large amounts, he tried to reduce his consumption. However, when he stopped taking Nurofen Plus®, he started ‘getting physical symptoms of withdrawal’ and would feel ‘really crap’ ‘psychologically’.
Sean went to see his GP, who put him on a ‘reduction regime’ in order to manage the withdrawal symptoms he was experiencing. This involved taking a gradually reduced dose of prescribed codeine. However, he found that this didn’t give him the ‘warm and cosy’ feeling he enjoyed when taking larger amounts of Nurofen Plus®, and after some time, he stopped taking the prescribed codeine and resumed taking Nurofen Plus®, while trying to keep his consumption to smaller amounts.
A few years ago Sean began seeing an alcohol and other drug psychiatrist who prescribed him opioid pharmacotherapy treatment (buprenorphine). Taking buprenorphine reduced his desire for Nurofen Plus®, and made it ‘easier’ to stop taking it without feeling any ‘craving’. Over the next three years, he gradually reduced his dose of buprenorphine and stopped taking it around six months before the interview.
Although Sean now feels that many ‘types of drug use’ no longer ‘hold any appeal’ to him, he doesn’t plan to stop taking drugs altogether and continues to occasionally smoke cannabis and drink alcohol. While prescription opioids continue to hold some appeal for him, he says he remains wary of their ‘double-edged’ allure.
Sean adores his large family – notwithstanding the considerable challenges that come with raising children – and being in a relationship full of love, passion, ideas and adventure. He is committed to living a thoughtful and ethical life in his work and everyday encounters.
According to Sean (M, 48, works in education, OTC painkillers), taking Nurofen Plus® ‘felt like an emotional regulator’ that helped him cope at work during a difficult time in his life.
It was a pretty horrendous time in my life [around the time of my separation from my previous partner…] I was kind of working quite regularly and functioning fine. You know, I remember, for example, having to go [to a meeting…and] I thought, ‘I’ll go and get a coffee and a packet of Nurofen Plus’, as you do, [then] swallowing the Nurofen Plus, going to […the meeting] and sitting there and just having this nice sense of, ‘Okay, in about ten or fifteen minutes I’m just going to get this nice, warm glow and the next six hours will look after themselves’. That’s what it felt like, it just felt like an emotional regulator.
[…]
I can work when I’m depressed, but it’s not great, it’s a pretty miserable experience […] Nurofen Plus didn’t stop me getting depressed, but I think it definitely […] just enabled me to go to work and […] just kind of focus on work and actually quite enjoy it, and it felt like I was kind of less assailed by, you know, the stuff […] that was preoccupying me the rest of the time.
Sean says having flexible working arrangements meant he could manage his Nurofen Plus consumption so that it didn’t impact on his work. (Played by an actor)
I think that [taking Nurofen Plus] enabled me to function in all sorts of ways that would have only benefitted my work […] It kind of contradicts that dominant story we have, particularly around, kind of, daily or dependent [drug] use, that [… it] will inevitably, kind of, lead to some sort of shameful […] exposure at work or calamity. That just was never the case for me […] I was incredibly lucky to be in a workplace where I was part time, that was flexible […] where I was trusted, and for good reason, you know. I certainly never saw the drug use being in any way a violation of that trust but it just meant that I could just sort of choose my hours and as long as I produced the work, it didn’t really matter.
Sean found it hard to detox from Nurofen Plus® at home because he still had to manage his everyday responsibilities. (Played by an actor)
I was back on the Nurofen [Plus] then […] and I was still seeing the GP, but I think she was at a bit of a loss as to what to do because I refused to go into an inpatient detox […Then] towards the end of that year […] it was just kind of hellish, you know, because I would just try to detox myself and that was […] really impossible. If I had sort of a week or two with no responsibilities, no child care, whatever, [being] looked after, I could’ve managed it, but not on top of everything else […] I ended up going and seeing this psychiatrist who was fantastic [and] really lovely. And I still see him occasionally. I probably see him once every six months, and he suggested that I go on buprenorphine [to cut down and eventually stop taking Nurofen Plus].
Sean describes his experience of gradually reducing his buprenorphine dose. (Note: strong language) (Played by an actor)
I think I ended up going and seeing this psychiatrist […] and he suggested that I go on buprenorphine […] He started me on four [milligrams] and then I quickly went up to six to eight to 10 and I think it was 10 or 12 [milligrams] that I stayed on […] I think the most I’ve ever heard of anyone being on is 32 milligrams so 12 is kind of a middling dose, I guess. It’s such an odd drug […] but it was amazing […] I just didn’t have any withdrawals [from stopping Nurofen Plus…] I guess I was on buprenorphine then for [a few years] so I just came off [it…] I had a shitty time [coming off it] Even though I had kind of reduced and done it slowly, I was still staggered by how difficult it was coming off. I think the lowest the chemist could do was like one milligram I think, but even though I’d done it really slowly and not really felt it as I was coming down […] going from 1 milligram to nothing […] just made me realise what a powerful drug [buprenorphine] is even in really small doses.
Drawing on his experience, Sean describes the qualities of a good therapist. (Played by an actor)
I think, most importantly, I found [my psychiatrist] incredibly […] engaged and engaging. Like, incredibly sort of present whenever I was with him […] I think it was actually really liberating to […] go along and see someone at a time when I was incredibly vulnerable […] I think he’s a really smart guy and he continues to say things that surprise me and resonate with me personally […] I’ve just always had the sense that he […] cared and he did, you know. And I genuinely really like his company.