Night Nurse Addiction: Signs, Effects and Treatment
Night Nurse provides ‘symptom relief and aids restful sleep’ when suffering from a cold or flu, but can it cause addiction?
Suffering from a cold or flu virus can make us feel achy and shivery and have symptoms that prevent us from getting the rest we need.
One of the worst symptoms can be a persistent cough or blocked and runny nose, which can interfere with our usual sleep pattern. Is it any wonder why many people turn to night nurse capsules or syrup for relief?
In this article, we will look at the key ingredients of this common cold and flu remedy, its side effects and its risks.
We will also provide some valuable advice about taking this over-the-counter medication safely and who should avoid it altogether. Further, we will disclose how Night Nurse can make you feel and what signs to look out for that indicate you could have a problem with this medication.
On this page:
- What is Night Nurse used for?
- Ingredients
- Side effects
- Cautions
- Night Nurse & Alcohol
- Signs of addiction
- Withdrawal symptoms
What is Night Nurse, and how does it work?
Night Nurse is a cold and flu remedy sold in tablets (capsules) and liquid form. This medicine can be purchased from pharmacies without a prescription.
Most people who take Night Nurse will follow the instructions on the box and only take it for a few days to help with the worst of their symptoms. This can help to speed up the recovery process as it clears congestion and helps to suppress irritating nighttime coughs. Night Nurse also makes you feel drowsy, which can help you get a good night’s sleep.
Night Nurse also comes in a non-drowsy daytime formula known as Day Nurse. As the name suggests, Night Nurse medication is only meant to be taken at night, just before bedtime.
Night Nurse Products:
- Day and Night Nurse capsules (for 24-hour relief from cold and flu symptoms)
- Night Nurse tablets (for relief of cold and flu symptoms at night)
- Day Nurse tablets (a non-drowsy medication for daytime relief)
- Night Nurse syrup (for relief of cold and flu symptoms at night)
Night Nurse ingredients
Per adult dose, the ingredient in Night Nurse that helps you to sleep is an antihistamine called Promethazine Hydrochloride (20mg), which also acts as a decongestant and stops runny noses.
Night Nurse also contains an ingredient called Dextromethorphan (15mg), which helps to ease a dry or tickly cough.
Additionally, this medication contains paracetamol (100mg per dose). The syrup formula of Night Nurse, which is potentially a higher risk for addiction, also contains ethanol (alcohol 18%).
Because of the ingredients within Night Nurse, it is essential that you do not take any additional paracetamol at night or drink alcohol with it.
Equally as important is that you avoid taking sedatives or at least consult your pharmacist before taking this medication.
Sleeping tablets such as Zopiclone, opiates and benzodiazepines will increase feelings of Night Nurse drowsiness, as well as some antidepressant medications.
Day Nurse, which can be taken during the daytime, contains an ingredient called pholcodine and is a non-drowsy medication. Some may understandably confuse pholcodine with codeine. However, pholcodine is considered non-addictive as it is not metabolised into morphine, unlike codeine.
Phlocodine acts as a cough suppressant and will not make you feel high.
Night Nurse side effects
As with most medications, there is a possibility of side effects of Night Nurse.
Common side effects of night nurse tablets and syrup include:
- Drowsiness
- Dizziness
- Clumsiness
- Blurred Vision
- Stomach Upset
- Difficulty concentrating
- Dry mouth
- Headache
The effects of Night Nurse last for approximately 12 hours.
This means that you may still feel its effects the following day. You should ensure that you are not affected by Night Nurse before you drive or operate heavy machinery.
Who should not take Night Nurse and who should exercise extreme caution
Some people will be at higher risk of abusing or developing a Night Nurse addiction. Ideally, these people should look for safer alternatives and avoid this medication altogether.
Who should avoid taking Night Nurse:
- Anyone with a previous history of abusing alcohol or sedatives
- Anyone who has or has had an alcohol use disorder (alcohol abuse or alcohol dependence)
- If you have an allergy to any of the ingredients within Night Nurse
- If you have a chest infection, uncontrolled asthma or respiratory problems, Night Nurse could make your breathing worse
- Anyone who has taken monoamine oxidase inhibitors (MAOIs) prescribed for depression in the last two weeks
Please exercise caution and consult your doctor first:
- If you are taking sedative medications already
- You are pregnant or breastfeeding
- If you are elderly and prone to falls or confusion
- Suffer from diabetes as Night Nurse contains sugar
- You are on a sodium-controlled diet. Night Nurse also contains sodium
- Have liver, urinary or kidney problems
Possible drug interactions with Night Nurse:
The following medicines may interact with Night nurse and may be unsafe to mix. Please consult your doctor first if you are taking any of the following medications:
- Tricyclic antidepressants
- Selective serotonin reuptake inhibitors (SSRI) antidepressants
- Medications which cause Central nervous system (CNS) depression, including antipsychotics, hypnotics and anxiolytics
- Medications with anticholinergic effects (e.g. benzodiazepines, barbiturates, amitriptyline, muscle relaxants and some antidepressants)
Elderly individuals should be cautious when using Night Nurse, as they are more likely to experience anticholinergic side effects such as confusion and paradoxical stimulation.
Children are also more likely to experience the adverse effects of Night Nurse, such as dry mouth, drowsiness, clumsiness, unsteadiness and blurred vision. This medication is not recommended for children under the age of 12.
Which is safer, Night Nurse syrup or tablets?
Night Nurse syrup contains alcohol and, therefore, has a higher potential for abuse and addiction in those with alcohol use disorders (AUDs).
There is also a temptation to gulp the medication from the bottle rather than using the measuring device supplied.
Medical studies have shown that liquid extracts have a faster absorption rate when compared to tablets. However, this could prove to be a double-edged sword as a person may be tempted to take more tablets than instructed when they do not feel speedy relief from their symptoms or the onset of sleep.
There is no straightforward answer regarding which form of Night Nurse is the safest. It depends on the person. You should always speak with your doctor or pharmacist if in any doubt.
Night Nurse is safe to take, providing you follow the instructions and dosages and do not take it any longer than a few days.
Night Nurse and Alcohol
Mixing Night Nurse and alcohol can increase side effects such as drowsiness, dizziness and confusion. You are also more likely to feel unsteady on your feet and be unable to recall events that took place whilst under the influence (blackout)
Promethazine, an antihistamine, can be used off-label in some cases to assist with sleep and is seen as a safer alternative to sleeping tablets and medications. Promethazine is, however, abused and is one of the key ingredients (along with codeine) in the popularly abused drink known as Purple Dank or Lean.
Abusing Night Nurse by mixing it with other addictive substances such as alcohol, sedatives, or opioids increases your chances of developing a Night Nurse addiction.
Alcohol and promethazine together can make you sleep very deeply and also affect your breathing whilst you sleep, putting you at risk of overdose.
The Signs of Night Nurse Addiction
The indications are that you should not take Night Nurse for any longer than three consecutive days. If you do, you risk becoming addicted.
Night Nurse addiction occurs when a person abuses the medication or takes it for longer than indicated. Continually taking Night Nurse puts you at risk of developing Night Nuse dependence.
Abuse and Addiction
Because of the ingredients within Night Nurse it is possible to become addicted. Addiction is the most severe form of a substance abuse disorder and usually starts with abuse of the medication. However, it is possible to develop Night Nurse addiction and dependence even at therapeutic doses.
If you have an addiction to this medication, you may feel that it isn’t that serious. However, there can be genuine long-term health consequences that result from Night Nurse addiction and abuse.
Risks of Night Nurse Abuse
- Frequently taking more paracetamol than clinically advised can lead to serious damage to your liver, to the point where you may require a liver transplant.
- Abuse of high amounts of Dextromethorphan contained within Night Nurse can result in psychosis, loss of consciousness, seizures, brain damage, hyperthermia and death.
- Promethazine abuse is associated with long-term side effects, including heart arrhythmias, low blood pressure, liver damage, bone marrow suppression and trouble regulating body temperature.
- Overdose, coma and death
How do I know if I’m addicted to Night Nurse?
If you notice any of the following signs whilst taking Night Nurse, it could be a sign that you have developed a dependence or an addiction.
- You take the medicine for longer than advised.
- Taking higher than the recommended dose of Night Nurse to feel its effects
- You take the medication other than to relieve cold and flu symptoms (i.e. to sleep or feel drowsy)
- When you stop taking Night Nurse, you develop withdrawal symptoms and feel unwell. These symptoms are relieved by taking more Night Nurse
- You combine Night Nurse with alcohol or other drugs to increase its effects
- You buy Night Nurse from different locations to avoid suspicion
Night Nurse abuse and addiction is a serious medical condition that requires treatment. Not all substance use disorders are related to illegal or controlled drugs. It is just as easy to develop a substance use disorder as an over-the-counter medication with addictive properties. In this respect, Night Nurse is no different to other drugs.
If you are not too severely affected, you may be able to stop Night Nurse by yourself. However, if you are unable to control or feel very unwell on stopping, then you should seek medical and professional help immediately.
Night Nurse withdrawal symptoms
Night Nurse withdrawal is a set of symptoms that develop from Night Nurse dependence. Taking more Night Nurse will relieve these symptoms as a short-term measure. However, drug tolerance and dependence become increasingly worse the longer it goes on.
Depending on your levels of tolerance and dependence on the drug will affect how severely you experience Night Nurse withdrawal symptoms.
Signs of Night Nurse withdrawal include:
- Difficulty falling and staying asleep (insomnia)
- Feeling restless and easily irritated
- Agitation
- Anxiety or panic
- Experiencing palpitations or irregular heartbeat
- Sweating
- Headaches
- Nausea or vomiting
- Diarrhoea
- Tremors
- Difficulty regulating your temperature, hot flashes and shivering
For anybody affected by a Night Nurse dependence or addiction, withdrawal symptoms can be successfully diminished and safely managed with a medical detox.
Get professional help now
As you can see, anyone can potentially develop an addiction to Night Nurse if they do not follow the instructions and cease use after three days.
The first step in recovery is admitting your problem and asking for help. Our CQC-registered detox and rehab centres can assist you in making a full recovery from Night Nurse abuse and addiction.
Detox Plus UK provides
- A full bespoke medical Night Nurse detox, supervised by medical nursing staff trained in the detoxification process
- Comfortable and temptation-free surroundings
- A bespoke rehabilitation programme targeted at unearthing and healing the root causes of addiction
- Proven relapse prevention techniques
- A multidisciplinary team of professionals, including doctors, nurses, counsellors and therapists
- Affordable rehab in a location of your choice
- Free aftercare programme on completion of your treatment
If you are still unsure whether you would benefit from treatment for a problem with Night Nurse, call our team for a friendly and informal chat. We are here to listen to your story and help in any way we can.
References:
- Night Nurse patient leaflet: https://www.medicines.org.uk/emc/files/pil.354.pdf
- Night nurse:https://www.medicines.org.uk/emc/product/354/smpc#gref
- Liquid Extracts Vs. Capsules/Tablets:https://medicare-europe.co.uk/science-clinical-data/liquids-vs-pills.html
- Promethazine (Phenergan) – Other brand names: Avomine, Sominex: https://www.nhs.uk/medicines/promethazine/
- Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601090/
- Cough and Cold Medicine Abuse:https://kidshealth.org/en/parents/cough-cold-medicine-abuse.html
- Promethazine:https://www.drugwatch.com/promethazine/
