[Acutulus]

Speaking for the US, yes indeed. Loperamide is technically an opioid and available OTC, though that's rarely a sought after compound unless one is in dire straits.

Codeine is available with a pharmacist's approval alone in my state. So while it may not technically OTC by that definition (or is, I don't know how OTC is defined), it can be had without a prescription by visiting a participating pharmacy and simply requesting codeine+guaifenesin. Done it a few times myself.

[SOLAR_FIELDS]

Codeine + cough syrup is so popular in Texas that it spawned an entire subculture dedicated to its use. See DJ Screw in Houston (https://en.m.wikipedia.org/wiki/DJ_Screw).

Lest you think this is no longer the case - “lean”, as it is known by Houstonites (due to your tendency to lean on things while under the influence) was a major plot point of a recent mostly autobiographical Netflix series centered around Houston that was released late last year: https://www.keranews.org/arts-culture/2022-08-25/houston-ooz...

[Acutulus]

Vice released an excellent short piece on Houstonian screw & slab culture years back. Might still be on youtube! It was an excellent piece at the time, but I haven't seen it in quite a while.

[montecarl]

For clarity, loperamide, sold under the brand name Imodium, is an anti diarrhea medication. It is an opioid; however, it does not readily cross the blood-brain barrier. It only acts on the opioid receptors in the large intestine and slows the movement of food. In very high concentrations it may get into the brain.

[lotsofpulp]

If I go to a developing country where I cannot guarantee access to a bathroom, I pop one or two of these every morning to keep me regular.

[throwanem]

"A pharmacist's approval" is a prescription, just one that happens to be written by the same person who fills it. So no, not OTC, which specifically refers to medications you can get without a prescription.

[benj111]

I suspect this is location specific though. In the UK my migraine medication was available over the counter, I still had to have a discussion with the pharmacist every time I bought it. Conversely when ever I've needed an actual prescription medication, in an emergency or whatever, that has always had to go through my doctor to get the prescription sorted.

[denton-scratch]

/me also a brit.

My go-to pain-relief used to be a product called Codis, which was soluble aspirin+codeine. It used to be available OTC, until about 8 years ago, then it disappeared. You can still buy paracetamol+codeine OTC ("Paracodol?). My understanding is that aspirin causes vasodilation, which causes more rapid absorption of codeine. Supposedly that's why Codis worked better than Paracodol.

I don't know why they took it off the shelves. There was no announcement; it just disappeared.

Codis was effective for both migraines and period pains, as reported to me (I'm not a woman, and I don't suffer from migraines).

[benj111]

This was migraleve it didn't have any painkilling element in the first tablet (it was 2 parts) not much point anyway as by that point I was throwing up.

[deathclassic]

asprin + codiene sounds like a based painkiller combo. Who needs a liver tbh?

[heavyset_go]

It's paracetamol that's hard on the liver, not aspirin or codeine.

[throwanem]

Well, sure, countries will have their own laws over this or anything. Ours are defined at the federal level and thus apply the same everywhere in the country; since GGP and I are both USian, that's the basis on which I replied. (I don't know enough about any other country's such laws to speak to them!)