Codeine Addiction and Abuse

Codeine is an opiate widely prescribed for the treatment of pain relief. However, It is a drug that is widely misused by young adults due to its influence and popularity in pop culture.

Codeine addiction | Table of Contents

Understanding Codeine

Codeine is a prescription pain-reliever that is widely utilized to treat mild to moderate pain. It’s the primary ingredient in prescription cough medications as well as other popular painkillers. The most popular painkillers are a combination of Acetaminophen and Codeine.

Codeine is an opiate (sometimes referred to as narcotic) that is mainly available in tablet form. Street names of this drug may include; cough syrup, t-three’s, schoolboy, and coties.

Codeine operates by stimulating opioid receptors in the brain to help slow down certain nerve signals that cause pain or the urge to cough.


How does Codeine work?

Codeine operates in the central nervous system and the brain by blocking pain signals in the body.

How long do Codeine pills stay in your system?

Codeine can be spotted in urine for up to 48 hours after the last drug dose. However, it can be detectable in chronic users for up to 1 week. It can also be detected in saliva for up to 21 hours after the last dose and in hair follicle tests for up to 10 weeks.

Codeine Effects, Abuse, and Addiction

Addiction to Codeine may start off innocently through the consumption of Codeine-based cough syrup for genuine health conditions.

As Codeine is less regulated than other dangerous opiates (such as OxyCotin and morphine), accessing and abusing it is quite easy. The lack of regulations put in place despite the fact that Codeine’s chemical structure is similar to that of Hydrocodone and Morphine is quite alarming. Although less potent, Codeine provides effects that are akin to morphine but in less severe forms.

Some of the effects of Codeine are:

  • Apathy
  • Drowsiness
  • Euphoria
  • Relaxation

The development of tolerance and, eventually, dependence is very high during codeine consumption. Many individuals may use this drug initially for the treatment of legitimate health conditions but begin misusing it soon after developing a tolerance to the drug.

Prolonged misuse of Codeine in this manner can quickly develop into an addiction. Codeine may mislead users into a false sense of security because most people do not regard it as a powerful or addictive substance like other opiates.

Unfortunately, Codeine abuse is considered a gateway drug to other opiate abuse and addiction.

Side Effects of Codeine

Codeine functions by slowing down the nerve signals when interacting with the brain. The side effects of this drug are directly linked to this function of Codeine. The side effects of Codeine can range from mild to severe. Many factors, such as the user’s health condition and the amount of drug used, may also help determine the immediate side effects of Codeine use.

Some of the short-term side effects of Codeine use include:

  • Itching or rash
  • Nausea
  • Drowsiness
  • Dry mouth
  • Blurred vision
  • Constipation and stomach cramps
  • Dizziness
  • Seizures
  • Low blood pressure

Prolonged Codeine misuse can cause health complications and maladaptive behaviors.

Here are a few of the long-term side effects of Codeine:

  • Anxiety
  • Fatigue
  • Liver damage
  • Kidney damage
  • Muscle spasms
  • Impaired memory
  • Death
  • Depression


Can Codeine be taken long term?

Long-term effects of codeine misuse or addiction are insomnia, nightmares, and liver damage. Therefore it is recommended to be taken only as prescribed by a medical professional.

Who Misuses Codeine?

Studies have observed that men misuse Codeine more often than women. College students also tend to take the drug as a CNS depressant to promote feelings of relaxation, while professional athletes are also known to abuse the medication for no genuine health-related reason.

Young people misuse Codeine for recreational purposes. The “purple drank” has become one of the most common forms of Codeine abuse amongst young adults. It is often their way of experimenting with the effects of addictive substances. However, since Codeine is only 8-12 percent as potent as pure morphine, these individuals may eventually start abusing other stronger substances such as heroin and morphine after finding Codeine less effective.

Purple Drank

Codeine cough syrup is the main ingredient of purple drank,” a drink made for vast recreational consumption by combining Codeine with soft drinks such as Mountain Dew or Sprite. This drink is also referred to as sizzurp, lean, and syrup.

The Codeine-combined drink is referenced in many popular songs and TV shows. Making this extremely popular among young adults.

Signs of Codeine Abuse, Addiction and Dependence

Although Codeine is relatively less addictive than other opiates, a user can still develop a tolerance or dependence on it. The legal availability of Codeine makes it harder to differentiate between general use, addiction, and misuse. However, a few notable signs can reveal dependence; for example, a person may increase the dose beyond the prescription and ignore personal responsibilities. Here are a few other physical signs to help identify Codeine abuse.

Some of the signs of Codeine abuse are:

  • Slurred speech
  • Impaired judgment
  • Drowsiness
  • Dilated pupils
  • Lack of coordination
  • Short attention span
  • Apathetic behavior

Medical experts and addiction treatment specialists refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to help diagnose Codeine dependence. Codeine addiction or dependence is generally classed as mild, moderate, or severe, depending on which treatment is provided.


How long will it take Codeine to work?

That depends on the type of codeine consumed. For instance, codeine injections provide instant relief from pain. Codeine tablets, liquid syrup, and cough syrup, on the other hand, take around 30 to 60 minutes to work and wear off after a few hours.

Can you take Codeine daily?

Codeine is best when taken at the lowest effective dose for the shortest duration of time. This dose can be taken for up to 4 times a day at intervals of 6 hours. The maximum daily dose should not surpass 240 mg in any way. For adults, this ideal dose should be around 30-60 mg every four hours to a maximum daily dosage of 240 mg.

Does Codeine lose potency?

Most of the drugs are dated to expire after one to five years, but the time frame does not necessarily correspond to the potency of the drug.

Tolerance and Dependence

Many confuse the difference between drug tolerance and drug dependence. Although it may sound the same, it differs in how each affects our body and brain.

Drug tolerance refers to when a person no longer responds to the same dosage and requires higher doses of the drug to feel the desired effect. This is why those who are addicted to a specific drug desire more and more of the drug over time. Drug tolerance is generally an early sign of an addiction.

Dependence refers to when a person requires the drug to function as normal day-to-day. Dependence may lead an individual to experience adverse physical and psychological withdrawal effects during the abrupt cessation of the drug. While long-rem use of any drugs can result in the formation of dependence, it does not necessarily mean they are addicted.

Codeine and Other Drugs

Codeine has been known to be a gateway drug to other substance abuse. For some individuals, it is the first step towards other potent substances like Morphine, Heroin, or Oxycodone.

Some users may also opt to combine alcohol or other opiates with Codeine to enhance its effects. Combining such substances together is referred to as polydrug abuse. This form of abuse highly increases the chance of an overdose. Combining opiates with alcohol can cause effects such as drowsiness, dizziness, loss of motor control, respiratory issues, memory loss, or even death during extreme circumstances.

The Dangers of Codeine

Although Codeine is less potent than Morphine or Oxycodone, it can still induce effects akin to such opiates when taken in large doses. Codeine has a similar chemical structure to that of Hydrocodone and Morphine, hence causing the same reactions in the user’s body. The side effects of the drug can occur as early as the first consumption and rapidly worsen over time.

Many people regard Codeine as harmless due to its use as a prescription medication. However, it can result in adverse side effects when taken in large doses. A few of the dangerous side effects of Codeine in high doses include coma, respiratory failure, and even death. The risks of these side effects tend to get higher when the user combines Codeine with other CNS depressants, such as alcohol.

Codeine Misuse Statistics

  • 33 Million: About 33 million people in the US use Codeine every year.
  • 4.7 Million: About 4.7 million US citizens use painkillers for non-medical purposes, as per the National Survey on Drug Use and Health (NSDUH-2008.)
  • 152%: Emergency room visits for painkiller-related issues increased by 152 percent between 2004 and 2008.

What is Codeine Withdrawal?

When an individual builds up a tolerance and physical dependence on Codeine, the brain fails to function normally without the drug. If the user tries to quit Codeine use at this stage, withdrawal symptoms can occur until the brain adapts itself to function without the drug.

Withdrawal symptoms can consist of physical and emotional discomfort and may vary from person to person. The duration of withdrawal and its severity may also differ from one person to another based on factors such as:

  • The average dose of Codeine regularly consumed
  • The frequency of Codeine use
  • Polydrug abuse
  • The duration of Codeine use
  • How Codeine was administered
  • The user’s mental health, medical history, gender, and body weight

Symptoms of Withdrawal

A person with a severe addiction to Codeine can experience intense withdrawal symptoms even after a few hours of taking the last dose. Codeine withdrawal symptoms are quite similar to the withdrawal symptoms caused by other known opiates and range from moderate to severe.

Typical symptoms of Codeine withdrawal are:

  • Insomnia
  • Muscle aches
  • Nausea
  • Headaches
  • Sweating
  • Fever
  • Diarrhea
  • Dehydration
  • Vomiting
  • Depression
  • Cravings
  • Stomach pains

Although the above-mentioned withdrawal symptoms are not fatal, the severity of those symptoms can worsen over time. For example, dehydration caused by Codeine withdrawal can turn life-threatening without proper treatment. Medical detox is highly recommended to avoid complications and relapses.

Duration of Withdrawal

The duration of withdrawal symptoms can vary from person to person, with the most adverse symptoms lasting for about a week. The emotional and mental complications associated with Codeine withdrawal can last for many months. For example, the depression caused by abruptly quitting Codeine can even last a year.

The detox method also determines the symptoms’ severity and duration. While medically-assisted detox is usually safe, detox without professional support can make things worse. A tapering down program minimizes withdrawal symptoms to a greater extent but can take weeks or even months to complete.

Codeine Withdrawal Timeline

Days 1-4

Withdrawal symptoms usually peak within this timeframe. Insomnia, muscle pains, headaches, restless legs, nausea, vomiting, sweating, and diarrhea are some of the most common symptoms experienced by Codeine users during this period.

Days 5-7

Physical symptoms begin to fade, while psychological symptoms begin to develop. For example, users may feel depressed and dispirited during this timeframe. Users can also experience dehydration from excessive sweating and diarrhea.

Days 8-30

Withdrawal symptoms would have already disappeared by this time. However, mental disorders, such as depression, can still persist. Patients may still experience cravings for Codeine even months after cessation.

Keys to Coping with Withdrawal

Although medical detox is the safest approach to overcoming Codeine addiction, withdrawal symptoms can complicate the process. Thus, various coping methods have been discovered to alleviate withdrawal symptoms and to help patients face rehab safely.

Professional care is key here. While you may want to keep your addiction a secret and detox on your own, it is not safe. Most patients experience adverse side effects when attempting to quit drug use cold turkey. So why would you take a risk when treatment specialists are available across the US? Outpatient and inpatient treatment centers are well-equipped to offer professional care for SUD patients.

Emotional support from loved ones can help you immensely in managing mental struggles. Hence, spend more time with your family and friends and avoid people who use Codeine or encourage you to use Codeine. Such individuals can cause a great hindrance to your overall recovery. Counselors and support groups can also be a great source of emotional support throughout your recovery journey.

Why Do You Need Codeine Addiction Treatment?

While it may seem fun or pleasurable initially, addiction to any drug can gradually take a toll on your life. Prolonged misuse of any drugs can result in impaired mental and physical health. It can also negatively affect personal and professional lives and cause damage to relationships.

Experimenting with Codeine may seem innocent at first, but it can easily snowball into something much worse. Many people who misuse Codeine tend to move onto other potent variations, such as Morphine and Heroin. Thus, treating any addiction at the earliest stage prevents complications, adverse health issues, and fatal overdose.

Treatment for Codeine Addiction - Codeine Detox

The initial and primary step during addiction treatment entails detoxification. This procedure helps individuals flush out all traces of the drug over a certain time. While abruptly quitting Codeine may speed up the detox process, it may also lead to adverse withdrawal symptoms. Therefore, medical detox under tight supervision is the best and safest choice for those diagnosed with severe addiction. Medical detox involves the use of certain medications to help relieve severe withdrawal symptoms during detoxification while decreasing the chances of relapse or complications.

Medications during detoxification may include; Suboxone or Methadone. However, patients should be made aware of their addictive features. It is vital to adhere to doctors’ prescriptions to prevent unnecessary complications. The patient must also ensure to use such medications only under medical supervision.

A tapering-down program is another safe approach to overcome Codeine addiction without its intense withdrawal symptoms. The patient will be guided by a doctor to reduce Codeine doses over a period of weeks or months until there’s no more Codeine in the system. This method minimizes withdrawal symptoms to a greater extent. A medical expert will monitor the patient throughout the process to ensure the patient is coping well with their withdrawal.

Treatment Center for Codeine Addiction - Inpatient Rehabilitation

Inpatient rehabilitations provide patients with a structured environment void of all distractions and temptations. These centers provide specialized support and counseling to help patients with their recovery process by teaching them to make healthy life choices and educating them on relapse prevention techniques. These combined treatments are highly beneficial for patients with co-occurring disorders and polydrug abuse.

Providing continuous treatment and keeping patients safe is a top priority of inpatient rehabs. The duration of treatment may vary from one patient to another. While treatment for Codeine generally lasts 30 to 90 days, those with a mild addiction may require less time.

Ongoing Recovery

Ongoing treatment is crucial after the completion of inpatient rehab, especially for individuals who suffered severe Codeine addiction or are at a higher risk of relapse.

Counseling sessions and support groups keep patients away from impulses and help them maintain long-term recovery. Ongoing therapy also helps people address and manage cravings, long-term withdrawal symptoms, and underlying issues that led them towards addiction in the first place.

It is vital to understand that the battle of addiction is a life long process, and ongoing treatment is essential to maintain long-term sobriety.

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