Codeine is the generic name for codeine phosphate.

It is derived from poppies and belongs to the opioid family of narcotics. It is often prescribed as a pain reliever, but can be used to treat other ailments, such as diarrhea, cough, and mild inflammation. Codeine is an active ingredient in cough syrup and capsules, and it can be highly habit-forming if not taken for medical reasons, without a prescription, or in excess of the required dosage. 

Codeine abuse and repeated use can be detrimental to an individual’s mental, physical, and emotional health. If an addiction is present, professional therapy and treatment can help to manage withdrawal symptoms during detox and to address the root causes of the substance abuse. With the right care, people can leave codeine abuse in the past and move forward to a healthy, balanced life in recovery.

Major Effects of Codeine Use

As substances and the body an active ingredient in medicines like cough syrups, diarrhea medications, and pain relievers, codeine abuse is fairly difficult to track because it is available over the counter in pharmacies in many states. Over-the-counter codeine medications may carry small doses of the drug; it is available in large doses in prescription medications. Codeine can be found in medications, such as Tylenol #3, Paracod, and Empirin. According to the Global Information Network About Drugs (GINAD), the abuse of prescription drugs, including codeine, costs Americans more than $484 billion a year.

The effects of codeine are common to those of other narcotics. A small dose of the drug converts to morphine in the body, and similar to how morphine works, the drug binds to reactors in the brain that transmit pain throughout the body. Codeine helps to increase an individual’s tolerance for pain and discomfort. When taken, the individual feels a sense of calm and pleasure, which can lead to both a physical and mental dependence on the drug. Through extended use, the individual can develop a tolerance for the drug, therefore needing to take a progressively higher dosage in order to feel the drug’s continued effects.

Even when prescribed by a doctor, a person can become reliant on codeine. This is usually due to the feeling of euphoria that occurs once the drug has been ingested. Some of the common side effects of codeine when taken as prescribed are: 

    • Drowsiness 
    • Lightheadedness 
    • Dizziness 
    • Sedation 
    • Shortness of breath 
    • Nausea 
    • Vomiting 
    • Stomach pain 
    • Sweating 
    • Constipation 
    • Rash or itching 
    • Tolerance 
    • Dependency 
    • Depression 

According to the National Household Survey on Drug Abuse (NHSDA,) in 2007, 5.2 million individuals over the age of 12 reported using pain medicine, including codeine, recreationally. Using any drug, including codeine, without a prescription increases the risk of dependency and can lead to addiction over time. Overuse of codeine can cause serious health risks and may even result in death.

Health Risks
Since codeine is a drug that can be found over the counter in medications in some states, it often gives people the false impression that the drug is safe for use. However, just like any other drug, codeine needs to be used with caution and only as directed by a doctor.  

If abused, this drug can be just as harmful as heroin or opium. An overdose of codeine can cause respiratory depression. This occurs when the lungs do not function at their full capacity, which in rare and extreme cases, can lead to fatalities. Over a long period of time, codeine can have some serious effects on an individual’s mental and physical heath by causing:  

  • Damage to the kidneys and liver (This risk can be made worse when the drug is mixed with other drugs or alcohol.) 
  • Lowered heart rate and blood pressure 
  • Disorientation 
  • Difficulty concentrating and sleeping 
  • Severe constipation 
  • Convulsions 
  • Hallucinations 
  • Tremors 
  • Seizures 
  • Coma 
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    In 2011, the Drug Abuse Warning Network (DAWN) stated that the amount of nonmedical narcotic pain reliever-related emergency room visits increased 117 percent, from 168,379 visits in 2005 to 366,181 visits in 2011. When individuals abuse codeine for a long time, it can be dangerous to withdraw from the drug without the assistance of a medical professional. When those who are dependent limit their intake of codeine or stop taking the drug cold turkey, they may experience the following symptoms:  

    • Cravings 
    • Sweating 
    • Difficulty sleeping 
    • Nausea 
    • Diarrhea 
    • Muscle spasms  
    • Irritability   
Behavioral Changes
Codeine abuse, just like any other substance abuse, can change an individual’s behavior. Relationships, and responsibilities are often neglected and hobbies fall by the wayside. Individuals find themselves fixated on obtaining the drug and put all their energy into that task, as opposed to the things they used to enjoy. Other signs of codeine abuse include: 
  • Loss of appetite 
  • Sleeping too much 
  • Poor job performance 
  • Calling in sick frequently 
  • Loss of interest in friends of family 
  • Selling personal items 
  • Borrowing or stealing money 
Individuals may fake an illness to get a prescription from a doctor, claiming that their current dosage is not working, or saying that a prescription was lost. If these methods do not work, making a trip to the emergency room to obtain a prescription may hold the person over until the next doctor’s appointment when a prescription could be obtained. This type of behavior is a clear sign of dependency on the drug.

Relationship Conflicts or Abuse

  • Codeine abuse can cause serious harm to personal relationships. When people are abusing substances, they are no longer putting their family and friends above their need for the substance. This type of neglect or abuse can cause divisions between partners or spouses and often leads to divorce or even custodial loss of a child. The National Council on Child Abuse & Family Violence identifies parental substance abuse as a major factor in cases of child abuse and neglect. Statistics indicate that more than 8 million children have a parent who is a substance abuser.
  • It is often difficult for roommates, friends, and loved ones to understand that drug addiction is a disease that needs be treated by a medical professional, and not something that can be overcome by willpower alone. Comprehensive addiction treatment is needed to identify the issues that led to substance abuse and to learn ways to prevent future relapse back to codeine abuse.

Treatment for Codeine Abuse

Abuse getting treatment of codeine comes with serious risks, but comprehensive addiction treatment offers individuals a way out of substance abuse. If dependence has formed, withdrawal from codeine can be similar to withdrawal from other opiates. As a result, medical detox is required, and individuals should not attempt to simply stop taking the medication on their own. Due to withdrawal symptoms that can be harmful to an individual both physically and emotionally, medical professionals may choose to slowly taper the individual’s dosage of codeine to slowly wean the person off the drug. In other cases, medications may be given to mitigate the severity of withdrawal symptoms.  

Detox in and of itself is not addiction treatment; it must be followed by an addiction treatment program that addresses the reasons behind the substance abuse. Most programs use a combination of individual, group, and complementary therapies to form an individualized treatment plan for each client. The treatment plan should be reassessed throughout treatment, and approaches may be tweaked depending on the individual’s progress. An aftercare plan should also be developed to ensure the person has a firm plan in place to sustain sobriety after leaving a structured treatment regime.

It is never too late to ask for help with a codeine addiction. Whether codeine is abused on its own or in conjunction with other substances, professional assistance can help individuals to leave substance abuse in their past and move forward in recovery.