There's a horrible bathos to Mel Smith's story that he might well find quite funny if he hadn't nearly died. The comedian and film director admitted this week that he had developed a drug habit that left him exhausted, depressed and with two leaking stomach ulcers through which he lost dangerous levels of blood. His drug of choice was not cocaine (although he has "dabbled" with that) or even tranquilisers - but Nurofen Plus.
The agonising gout that prompted Smith to take up to 50 tablets a day was far from funny, but there is something grotesquely comical about him sneaking around his house attempting to conceal packets of painkillers from his wife. "Like the alcoholic hiding his bottles, I started hiding my Nurofen," he says. "It was terribly grubby."
David Grieve from Dumfries would not see the funny side either. He developed a 17-year addiction to the cough medicine Phensydyl, supporting a 90-bottle-a-week habit with a level of subterfuge that would impress the most cunning heroin user. Three days a week he set off on "trawling trips", travelling to pharmacies as far away as Manchester to avoid detection. The former policeman and psychiatric nurse would even impersonate a priest so that he could pass off his bulk buys as mercy missions for sick parishioners. In 24 months he spent £18,000 on his habit. "I loved my addiction more than I loved my wife or my family," says the 49-year-old. He kicked his habit in 1993 but is still unable to work having had his gall bladder, part of his liver and part of his pancreas removed as a result of the addiction.
There are no official statistics for the number of people addicted to over-the-counter (OTC) medicines, but Grieve estimates that there are 35,000 addicts throughout the UK. He now runs a self-help group called Over-Count for recovering OTC addicts, and has 8,000 people on his books, two thirds of whom are women. A survey for the consumer magazine Health Which? last year found that one in 10 of us pops a pill every day, while one in five women and one in eight men take medicinal drugs twice a week or more.
Mel Smith's dependence, like Grieve's, was probably due to codeine, an opiate derivative found in small quantities in the drug. "It is a very effective painkiller," says Dr Hamid Ghodse, professor of psychiatry and addictive behaviour at St George's hospital medical school in London. "But the side-effect of codeine, like heroin or morphine, is addiction and dependence."
Ghodse believes the peculiar set of circumstances that lead to an individual becoming dependent on an OTC medicine are more complicated than straightforward physical addiction. "Vulnerable people can become addicted because of their make-up, in particular if they have problems, mental or social," he says. "For most painkillers the question of psychological and physical dependence is very much inter-related."
Roger Odd, head of professional and scientific support at the Royal Pharmaceutical Society, agrees, stressing that misuse of OTC drugs is much more common than simple addiction. Laxatives, he stresses, are commonly misused by anorexics, even though there is no "addictive" quality in the drug. Nasal sprays, similarly, are not addictive in the sense that they prompt withdrawal symptoms if the treatment is stopped. Misusers simply come to like the pleasant sensation given by the propellant.
"All of these products if they are used appropriately are perfectly all right," he stresses. "There are no problems from a dependency point of view with aspirin, ibuprofen or paracetamol. You shouldn't, of course, take paracetamol in large doses as you can get irreversible and sometimes fatal liver damage, and aspirin is very acidic, which can cause stomach problems."
Grieve is trying to persuade pharmaceuticals companies to fund research into OTC addiction, but says that, so far, approaches to 160 companies have been met with closed doors. Last month he was approached by the head of the Alabama poisons bureau, who had been unable to find information about the problem elsewhere. "Five years ago I set up Over-Count with 25 clients. We are now growing at a rate of 1,500 clients a year. But the problem has never been officially established. You have to ask yourself why."
