Explain codeine dependence and OAT to a sceptical patient — CASC communication station

A 42-year-old teacher with 4 years of escalating codeine–paracetamol combination use (previously OTC, now multiple private scripts) is medically stable after an ED attendance for abnormal LFTs. She is offended by the referral to addiction services, says ‘I’m not a junkie — it’s from the chemist,’ and wants only ‘a letter so pharmacists stop judging me.’ She is ambivalent about methadone because of stigma but worried about her liver and her job.