Learn more about codeine, the side effects, long-term effects, risk for addiction, and treatment for abuse and/or addiction.
Codeine Side Effects, Addiction, and Treatment
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Codeine is an opiate drug similar to oxycodone, hydrocodone, and heroin. It is derived from the opium poppy and is a Schedule II controlled substance (it is sometimes considered a Schedule III substance) prescribed for pain relief and sometimes to suppress cough.
While codeine may seem milder than most opioids, it is still dangerous, especially when it is called something other than codeine. There are several different names for codeine and codeine mixtures.
Side Effects of Codeine
Codeine side effects can range from mild to severe. Knowing the symptoms can help determine when to call for help if needed.
- Shortness of breath
- Euphoria, or feeling high
- Dysphoria, or feeling uneasy, dissatisfied, or restless
- Slowed heart rate
- Cramping in the abdomen
- Digestive issues
- Dry mouth
- Sleep disturbances
The longer the use of codeine, expect an increase in these symptoms and more long-term, dangerous effects.
While visible signs may only last a few hours, codeine can remain in the system for 16 hours or longer.3 Factors that affect the length of time include:
- Body fat
- Body mass
- Liver and kidney health
Misuse or abuse of codeine can lead to addiction. It’s important to seek help if you’re addicted to codeine as you can end up with serious health issues. Call 800-407-7195(Who Answers?) to speak to a rehab specialist and discuss your options.
Long-Term Effects of Codeine
Abusing codeine long-term can cause problems for all parts of the body.4
Effects on the Brain
Because codeine alters neurotransmitters in the brain, symptoms of depression and anxiety may appear. Codeine also causes slower breathing and, if abuses, it may stop your breathing completely, either temporarily or permanently.
When you stop breathing, your brain starts to lack much-needed oxygen which can cause brain damage.
Opiates cause damage to the digestive system. For some, constipation is a big problem due to the digestive tract’s sedation caused by codeine use. This can lead to bowel obstructions, nausea, vomiting, and perforations.
Opiates like codeine, over time, make your body more sensitive to pain. The benefits provided in the beginning disappear, and instead of feeling less pain, it gets worse.
Acetaminophen toxicity happens when too much of it mixes with codeine. This means your liver cannot function properly. It can also weaken your immune system, making you more susceptible to viruses and infections.
Codeine addiction often develops due to misuse, which means taking more than prescribed, combining codeine with other drugs to achieve intoxication, or taking someone else’s prescription codeine.
Below are some signs you may have a codeine addiction:
- Misusing codeine prescriptions (lying to get additional drugs, doctor hopping).
- Spending time trying to find codeine.
- Mood swings from happy and relaxed to angry and aggressive.
- Experience withdrawal without codeine.
- Cravings for codeine.
- It is too hard to stop using codeine, even if it is causing consequences.
- Using codeine is interfering with the ability to work or have relationships.
- Build up of tolerance.
Treatment for Codeine Addiction
Treatment for codeine addiction is a process resembling that of most drugs. It is a step-down process like a pyramid, with the most intensive services at the top. Treatment begins at the top, and as you move down the pyramid, services become less restrictive and less intense.
The step-down process of treatment is set at your pace and based on your needs.
Step One: Evaluation
Treatment cannot begin until you receive an extensive evaluation from a licensed addiction specialist. The goal of the assessment is to gather the information that can help establish the correct diagnosis.
Evaluations include discussing you and your family’s medical, psychological, and addiction history. Your lifestyle, including home environment, habits, and support system, are also analyzed. Further assessed are areas of physical and mental health need.
Based on the information you provide, the mental health professional can make a recommendation for treatment. Depending on your level of codeine addiction, detox may be recommended.
Step Two: Codeine Detox
Detox can be difficult, that’s why most treatment facilities recommend a medically supervised detoxification. You are admitted into a hospital setting and given round-the-clock medical treatment.
Medication assistance eases cravings and negative physical symptoms during withdrawal. The time you spend in detox is focused mainly on ridding the toxins of codeine from the body so you can move to the next step with a clear mind.
Step Three: Inpatient Rehab
Inpatient rehabilitation services immediately follow detox and include medical supervision but in a residential setting. You can also receive multiple therapies that will strengthen you and prepare you to avoid relapsing with codeine in the future.
Inpatient rehab therapies include:
- Peer support counseling
You are also provided with education to learn life skills and understand addiction and why you became an addict. Call 800-407-7195(Who Answers?) to learn more about what inpatient rehab entails.
Many treatment facilities provide alternative therapies to overcome codeine addiction, such as:
- Art therapy
- Music therapy
You learn to set long-term and short-term goals and create a plan to reach those goals.
Finally, you learn specific relapse prevention skills before you step down to outpatient services.
Step Four: Outpatient Services
There are multiple types of outpatient services, all of which are beneficial.
Sober living homes allow you to move into a residence outside of rehab with other people in recovery. You have more freedom and get a chance to practice the skills you learned before returning home. You can stay in sober living for many months, allowing you to build confidence in your recovery while you attend meetings, get a job, and maintain peer support.
Intensive outpatient programs provide 10 or more therapy hours each week. The more support you can get early in recovery from codeine abuse disorder, the better.
Intensive outpatient treatment typically consists of attending multiple group, individual, and peer support therapy sessions weekly. Once completed, you can step down to individual counseling, support groups, or both.
Support groups are held in the community and meet daily in most places. Here, you get to receive and give support to others who understand opiate addiction.
Codeine and the Brain
Any opioid increases dopamine levels in the brain, sending signals to the rest of the body, telling it to feel good and to feel rewarded. The amount of dopamine released is much higher than what the brain can produce naturally.
When codeine starts to leave the body, the brain is triggered to want more codeine to feel good again. Over time, this can become a vicious cycle of trying to satisfy cravings and avoid withdrawal symptoms.
You may think prescribed codeine is not as harmful as illicit drugs, but just the opposite is true. Doctors consider many factors when choosing to prescribe it. Questions they may ask themselves include:
- Has the patient been taking codeine? If so, at what dosage?
- Does the patient have a tolerance?
- What is the current health of the patient?
- What is the medical history of the patient?
- What other medications is the patient currently taking? Will they cause an interaction with codeine?
- What type of pain is the patient having?
- How severe is the pain?
- Does the patient have risk factors for abuse? A prior history of abuse or addiction?
Even when doctors take precautions, you may experience side effects.
Most prescription drugs have brand and generic names, including codeine.
Codeine, or codeine sulfate, is considered an opioid analgesic drug and is often combined with over-the-counter type drugs, giving codeine even more names. Some examples include:
- Fioricet is codeine combined with acetaminophen and caffeine to ease headaches.
- Cotabflu is codeine combined with acetametaphen and chlorpheniramine for colds and flus.
- Tylenol with Codeine #3 is used to alleviate pain.
Other examples of codeine combination drugs, including codeine cough syrup, include Phenflu CD, Maxiflu CD, Nalex AC, Colorex Compound, and Pediatuss.
Slang names exist for codeine syrups mixed with alcoholic, non-alcoholic, or super-caffeinated beverages.
- Purple Drank
The body converts codeine into morphine once consumed. There are specific signs if you are intoxicated by codeine or other opioids.
- National Institute on Drug Abuse. (2021). National Institutes of Health. Opioid overdose crisis.
- U.S. Department of Justice. (2021). Drug Enforcement Agency. Diversion Control Division. List of controlled substances.
- Gans, S.M.D. (2021). VeryWellMind. How long does codeine stay in your system? Codeine in your blood, urine, hair, and saliva.
- Baldini, A., Von Korff, M., & Lin, E.H.B. (2012). A review of potential adverse effects of long-term opioid therapy: a practitioner’s guide. The Primary Care Companion for CNS Disorders, 14(3).
- National Association of Addiction Treatment Providers. (2021). Addiction treatment statistics.