Codeine Addiction

What Is Codeine?

Codeine is a prescription opioid combined with other medications (i.e., ibuprofen, aspirin, NSAIDs) to treat mild to moderate pain. It is intended for short-term pain relief and shouldn’t be used for longer than 3 days without consulting your doctor.

Common codeine prescription medications include:  

• Tuzistra XR: Prescription cough syrup that also treats runny nose and other cold symptoms (codeine + promethazine)
• Phrenilin w/codeine + caffeine: Prescription migraine treatment (acetaminophen, butalbital, codeine + caffeine)
• Tylenol 3 and Tylenol 4: Prescription pain medication (acetaminophen + codeine)

Codeine can extend the effects of some opioids (like morphine) but works differently than other prescription opioids.

Other prescription opioids include:

• Fentanyl
• Hydrocodone
• Oxycodone
• Oxymorphone
• Morphine

Codeine Abuse and Addiction

Codeine abuse occurs when the drug is used outside a doctor’s direction, such as taking more than needed, using it to get high, or taking it without a prescription.

Some people who abuse codeine will crush codeine pills and snort them. Codeine pills are also sometimes smoked or injected after being mixed with water.

Combining codeine cough syrup with alcohol or Sprite (a.k.a. “purple drank” or “lean”) has become more common among adolescents due to its popularity with certain celebrities and rap artists.

Codeine addiction may not be immediately obvious from the outside, but some tell-tale signs of addiction can include:

• Lying about codeine use
• Being unable to stop taking codeine
• Turning to other opioids when codeine is not available
• Experiencing withdrawal symptoms when not taking codeine
• Seeing different doctors to get multiple codeine prescriptions
• Stealing codeine or buying it illegally
• Isolation from family/friends

If you are concerned about your codeine use, the good news is that plenty of resources are available to help you get your life back to normal.

Codeine Abuse Side Effects

Although codeine is generally safe when prescribed by your doctor, some people can experience side effects, especially if taking it without a prescription.

Consuming other substances (e.g., alcohol, benzodiazepines) with codeine can also increase these side effects and the user’s risk for overdose or death.

Short-Term Effects of Codeine Use

• Stomach ache
• Constipation
• Increased heart rate
• Nausea
• Drowsiness
• Dry mouth
• Low blood pressure
• Impaired vision
• Seizure

Long-Term Effects of Codeine Use

• Headache
• Shallow breathing
• Challenge urinating
• Mood swings
• Dilated pupils
• Poor concentration
• Skin rash
• Problems with coordination
• Irritability/agitation
• Low sex drive
• Itching

Codeine Overdose

A codeine overdose can be fatal, especially when a person takes a large amount of the drug within a short period or has mixed codeine with alcohol or another drug (such as benzodiazepines or another opioid).

Some common symptoms of an opioid overdose (e.g., codeine) are:

• Increased, intense drowsiness
• Confusion
• Sweating
• Clammy skin
• Vomiting
• Convulsions
• Going in and out of consciousness
• Unconsciousness

What to Do for a Codeine Overdose

It is crucial to seek medical services immediately if someone you know has overdosed on codeine. A codeine overdose can cause a stroke, heart attack, seizures, coma, or death.

If you suspect someone is experiencing a codeine overdose, call 911 immediately and stay with the victim until help arrives. If possible, administer naloxone (Narcan) to help slow down the effects of the overdose.

Codeine Addiction Treatment

Treatment options for codeine addiction vary depending on the patient and the nature of their addiction.

Effective addiction treatment programs often involve behavioral therapy and counseling to address the psychological aspects of substance use disorder and help the patient develop healthy coping mechanisms to avoid relapse.

Codeine Detoxification

Usually, the first step in treatment for codeine addiction is medical detoxification.

Medical detox is the safest way to quit using codeine and enables you to avoid any potentially serious side effects.

During a medical detox, you will be monitored by medical staff (either at an inpatient treatment center or through check-ins) and sometimes prescribed medication to help your body adjust to the lack of codeine in its system.

If you’ve taken codeine for a while, withdrawal symptoms may occur during detox. Most symptoms subside within days or weeks, although some can last for months.

Because opioid withdrawal symptoms can be intense, medical professionals recommend seeking support through the detox phase.

Detoxing safely under medical supervision can alleviate many of these symptoms and ensure your safety while the codeine exits your body.

Some of the withdrawal symptoms you can expect from codeine withdrawal include:

• Sweating
• Nausea/vomiting
• Watery eyes
• Diarrhea
• Muscle twitches
• Body aches
• Runny nose
• Stomach pain or cramping
• Irritability/agitation
• Anxiety
• Cravings for codeine
• Restlessness

Medication-Assisted Treatment (MAT)

During detox and often throughout treatment, healthcare providers may prescribe certain medications to help alleviate withdrawal symptoms, manage cravings, and prevent relapse.

MAT may also be utilized to help the patient taper off their opioid dosage.

MAT for codeine addiction often involves one of the following medications:

• Naltrexone (Vivitrol®)
• Buprenorphine (Suboxone®, Subutex®)
• Methadone

Codeine Addiction Rehab Programs

Many drug addiction rehab programs exist for people who want help with their addiction to codeine. Counseling to help patients improve their mental health and well-being is typically a key component of any addiction rehab program, regardless of the level of care they provide

Typically, the following rehab programs are the most common:

• Inpatient rehab programs: Inpatient rehab for codeine addiction provides residential care for between 30 and 90 days. Patients check in to a treatment center that offers a structured environment where they can heal their physical dependence, develop healthy habits, and learn to manage triggers and cravings.
• Partial Hospitalization Program (PHP): A PHP is designed for individuals who require a similar structure and service that a residential program provides but go home daily. A PHP bridges the gap between inpatient rehab and other outpatient rehab programs.
• Intensive Outpatient Program (IOP): An IOP is ideal for individuals with a minor to moderate codeine addiction or for those who have completed a more substantial rehab program. Depending on each patient’s needs and goals, IOP can last anywhere from a few weeks to several months.

Codeine Statistics

Statistics about codeine are typically included in the overall prescription opioid statistics category.

The National Institute on Drug Abuse reports the following data about opioid abuse and overdose:

• An estimated 21-29% of patients with chronic pain misuse their prescription opioids
• Nearly 50,000 Americans died in 2019 due to opioid-involved overdoses, with that number rising to over 70,000 in 2021
• Each year, the opioid epidemic costs the US approximately $78.5 billion, which includes addiction treatment, criminal justice involvement, healthcare, and lost productivity

Find Help for Codeine Abuse and Addiction Now

From support groups and meetings to group and individual counseling, your much-needed addiction support may be easier to find than you think.

The U.S. Department of Health and Human Services created an online guide with opioid-specific addiction resources and information that can help someone addicted to codeine as well as their families.

Additionally, SAMHSA’s online treatment locator and free helpline (1-800-662-4357) offer a confidential way to search for treatment programs and addiction specialists throughout the U.S.

No matter what, remember that you aren’t alone in this struggle, and today can be the first day of getting your life back to normal.

If you’re ready to beat your addiction to codeine, learn your treatment and therapy options.