What is pethidine – and why is Call the Midwife's Dr McNulty so desperate for a dose?
The new doctor at Dr Turner's surgery is using pethidine as a painkiller. Here's what you need to know about this addictive drug
Call the Midwife's Dr Kevin McNulty is hiding a secret. The new young doctor, played by Lee Armstrong, needs the drug pethidine to function – and when his supplies run low, he's desperate to get his hands on another dose.
Dr McNulty says he needs the drug because he's in pain from an old shoulder injury, but it's looking very much like his usage has spiralled into addiction...
What is pethidine?
The opioid 'pethidine' is a synthetic, addictive, narcotic drug, similar to opium or morphine.
It was developed in Germany during the Second World War, and it soon became a popular drug prescribed by doctors to treat moderate to severe pain; you may also know pethidine by its brand name, Demerol.
The painkiller is often used during childbirth, but only during the first stage of labour before the pushing begins – so it doesn't affect the baby's breathing.
Pethidine can be administered as a syrup or as tablets, as we see in Call the Midwife.
However, during labour, it's usually injected into the mother's thigh or buttock to relieve pain and help them relax. The NHS estimates that it takes 20 minutes to work after the injection, and that it lasts from two to four hours.
Is pethidine addictive?
Yes it is! The drug was initially thought to be safer and less addictive than morphine – but this was false, and it carries an equal risk of addiction, even though the side effects can be less severe.
Repeated use of pethidine also leads to greater tolerance for the drug, and an addict will seek ever-higher doses.
What does withdrawal look like?
According to the product information, "Abrupt withdrawal of pethidine in those physically dependent may precipitate withdrawal syndrome, including convulsions."
Symptoms of withdrawal can include anxiety, paranoia, agitation, insomnia, restlessness, nausea, vomiting, muscle aches, sweats and chills, dry mouth, increased blood pressure, and even hallucinations.
Withdrawal typically kicks in between three and 24 hours after the user's last dose, and worsens over the next few days – unless the user gives in and returns to taking the opioid.
Call the Midwife continues on Sundays at 8pm on BBC One