What Is Codeine?
Codeine is an opioid that is combined with other medications for use as a painkiller, cough suppressant, and can also be found in some migraine medications. It is not intended for long-term use and treats mild to moderate pain.
Codeine is combined with other medications to make the following prescriptions:
- Tylenol 3 / Tylenol 4 — Codeine and acetaminophen combine to create this prescription pain medication. Tylenol 3 contains 30mg of codeine and 325mg of acetaminophen, and Tylenol 4 contains 60mg of codeine and 325mg of acetaminophen.
- Tuzistra XR — Promethazine /Codeine combination that acts as a cough suppressant and also treats runny nose and other allergy or cold symptoms. This medication is available as a prescription cough syrup.
- Fioricet w/codeine and Phrenilin w/codeine and caffeine: Used to treat migraines, this prescription medication combines butalbital, acetaminophen, caffeine, and codeine.
Codeine typically lasts four to six hours and takes less than 30 minutes to take effect. Codeine acts as a central nervous system (CNS) depressant and changes the way the body/brain responds to pain. Codeine also decreases activity in the brain, specifically the area that regulates coughing.
Codeine has a reputation of being a “weak” painkiller, which is wildly inaccurate. Codeine metabolizes into morphine in the body. The conversion to morphine can cause depressed breathing, resulting in accidental deaths.
This is the main reason the Food and Drug Administration (FDA) stated in 2017 that codeine was no longer appropriate for patients under the age of 18.
Opioids, including codeine, are high-risk for abuse and addiction. Codeine should only be taken as prescribed and only in the short-term.
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What Is Codeine Abuse?
Cocaine abuse is common among young people. They mix liquid codeine with soda, juice, and even alcohol in an attempt to get high.
These mixed drinks have been made popular by some famous people and are commonly referred to as Lean, Sizzurp, and Purple Drank.
Codeine in pill form is usually swallowed or crushed and snorted. Regardless of the method of ingestion, codeine abuse can increase feelings of relaxation and euphoria and cause a rush of dopamine in the brain. Each of these factors plays a role in developing an addiction.
Abusing codeine leads to tolerance, especially if codeine abuse continues for more than a few weeks. Opioids are highly addictive, and codeine is no different. Codeine abuse can result in tolerance, dependence, and addiction.
When a person develops tolerance, the same dose of codeine will no longer have the same effects.
If a person decides to take more codeine in order to continue to feel the same effects as the previous dose, they are likely to run out of their prescription before it is time to refill.
Side Effects Of Codeine Abuse
When a person abuses codeine, they are likely seeking euphoria and intense relaxation. However, in addition to the desired effects, there are numerous unwanted effects as well.
The more immediate effects of codeine abuse include:
- stomach cramps
- dry mouth
- blood pressure drops
- blurry vision
Over time, additional symptoms may occur, such as:
- mood swings
- shallow breathing
- difficulty urinating
- dilated pupils
- struggling to pay attention
- allergic skin reaction or rash
- coordination issues
- decreased sex drive
- flushing or itching
Long-term side effects of codeine abuse may also include:
- memory impairment
- muscle spasms
- kidney damage
- liver damage
High doses of codeine react in the body in a similar way as alcohol intoxication. Slurring words, nodding off, and lack of coordination can be a good indication a person who takes codeine has taken too much.
Codeine abuse is a key risk factor for opioid addiction. Codeine abuse can lead to tolerance and eventually dependence. When a person is codeine-dependent, they will experience withdrawal symptoms if they attempt to stop taking codeine.
In many cases, avoiding withdrawal is a reason for maintaining opioid dependence and potentially opioid addiction.
When a person is struggling with codeine addiction, they typically struggle with the side effects of codeine abuse. They may also show behaviors indicative of codeine addiction, such as:
- buying codeine illegally or on the street
- faking prescriptions for codeine
- doctor shopping (making appointments with different doctors to obtain multiple prescriptions)
- stealing codeine or money from others
- isolation from friends and family
- lying about drug use
- inability to stop taking codeine, even when they want to stop
- taking other opioids (oxycodone, hydrocodone) when codeine is unavailable
- having withdrawal symptoms when not taking codeine
- high risk for overdose
Codeine Abuse Rates In The U.S.
Many people in the U.S. struggle with codeine abuse. Prescription opioid abuse is often a precursor to heroin addiction.
- About 80 percent of people using heroin admitted they first abused opioid painkillers.
- On average, 130 people die every day from an opioid overdose.
- Two million Americans were abusing prescription opioids in 2014.
- In 2015, over 270,000 adolescents were abusing painkillers.
Symptoms Of Codeine Overdose
People who have a history of codeine abuse or addiction have a high risk of overdose. A codeine overdose can be fatal and is considered dangerous. When codeine metabolizes to morphine, it can result in severe respiratory distress.
Depressed breathing can deprive the brain of oxygen. Long-term decreased oxygen deprivation or complete oxygen deprivation for more than five minutes can cause permanent brain damage.
It is important to seek emergency medical attention if a person taking codeine seems to be struggling to breathe or shows any of the following symptoms:
- clammy skin
- nodding out
- becoming unconscious
Seeking medical services is important because, without intervention, a codeine overdose can result in heart attack, stroke, seizures, coma, and even death.
Can Codeine Abuse Lead To Withdrawal?
Since codeine abuse can lead to physical dependence, a person dependent on codeine will experience withdrawal symptoms when not taking the drug. Codeine withdrawal can be quite uncomfortable, and in some cases, incredibly painful.
Opioid withdrawal usually is not fatal on its own, however, it can cause significant distress and many individuals return to opioids early on in sobriety to avoid withdrawal.
Codeine withdrawal symptoms, like other opioid withdrawal symptoms, are very similar to severe flu-like symptoms.
In addition to muscle and body aches, vomiting, and diarrhea, a person experiencing codeine withdrawals may also have some of the following symptoms:
- watery eyes
- runny nose
- cravings for more codeine
- restless legs
The physical and flu-like side effects typically continue for about seven days, while the behavioral and emotional withdrawal symptoms can last for months after the last dose of codeine.
Because withdrawal associated with codeine and other opioids is so intense, it is strongly encouraged that the person finds a detox program that specializes in opioid addiction.
Programs equipped to help individuals with codeine addiction can offer support, medication, and supplements for clients.
Treatment Programs For Codeine Addiction
Substance abuse treatment programs that specialize in opioid addiction are called opioid treatment programs (OTPs).
These rehab programs use evidence-based intervention methods and comprehensive services for those struggling with an opioid use disorder.
Facilities that offer OTPs are monitored at the state and federal levels. These locations provide:
- thorough treatment planning
- vocational assistance
- educational services
- medical care
- medication-assisted treatment
- complete aftercare programs
Locating a facility for the treatment of codeine addiction can seem overwhelming. Our professional staff at Vertava Health of Massachusetts can discuss our opioid treatment program with you.
We can explain the benefits of our medication-assisted treatment approach and help you explore our other treatment methods which are effective for those struggling with opioid addiction, such as dialectical behavior therapy.
To learn more about the opioid treatment program at Vertava Health of Massachusetts, contact a treatment specialist today.
- Food and Drug Administration — FDA Drug Safety Communication: FDA requires labeling changes for prescription opioid cough and cold medicines to limit their use to adults 18 years and older
- Food and Drug Administration — Codeine label
- National Institutes of Health — Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures
- Mayo Clinic — Butalbital, Acetaminophen, Caffeine, And Codeine (Oral Route)
- American Society of Addiction Medicine — Opioid Addiction 2016 Facts and Figures